Integrative Medicine Research最新文献_第7页

Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map 中医治疗失眠：概括性回顾和证据图谱

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-06-01 DOI: 10.1016/j.imr.2025.101176

Jinxiang Wang , Bing Bai , Ranran Zhu , Xintong Yu , Xiaoting Xu , Xiaomin Tu , Lei Fang

Background

An increasing number of systematic reviews and meta-analyses (SR/MAs) suggests traditional Chinese medicine therapies are effective for insomnia. We aimed to synthesize and evaluate the methodological quality of these studies through an umbrella review with an evidence map for improving evidence quality.

Methods

We searched 10 databases from inception to March 20, 2025, that investigated the effects of TCM therapies on sleep-related subjective or objective outcomes for insomnia. We assessed the methodological quality of included SR/MAs using A Measurement Tool to Assess systematic Reviews (AMSTAR 2) tool, evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool, and visually presented the results as an evidence map.

Results

Thirty-six SR/MAs included in this umbrella review described 3 TCM non-pharmacotherapies (i.e., acupuncture, Tuina massage, and Chinese exercises), and Chinese herbal medicine (CHM). The AMSTAR 2 results showed that 20 SR/MAs had high or moderate methodological quality, while the remaining studies were of low or critically low methodological quality. The evidence map showed high-quality SR/MAs supported the effect of acupuncture, Tuina massage, Chinese exercises, and CHM on overall sleep quality, while acupuncture, Tuina massage, and Chinese exercises could also improve anxiety and depression. Moreover, acupuncture and Tuina massage might improve objective outcomes such as polysomnography parameters and 5-hydroxytryptamine level.

Conclusions

Acupuncture, Tuina massage, and Chinese exercises are effective in improving overall sleep quality and emotional outcomes and have potential effects on objective sleep parameters. There is sufficient evidence that several CHM formulas could improve sleep quality. However, the methodological quality of SR/MAs needs further improvement.

Protocol registration

PROSPERO, CRD42022347769.

越来越多的系统综述和荟萃分析（SR/MAs）表明，中药治疗失眠是有效的。我们的目的是综合和评价这些研究的方法学质量，通过一个综合评价和证据图来提高证据质量。方法我们检索了从成立到2025年3月20日的10个数据库，这些数据库调查了中医疗法对失眠患者睡眠相关的主观或客观结局的影响。我们使用评估系统评价的测量工具（AMSTAR 2）工具评估纳入的SR/ ma的方法学质量，使用建议评估、发展和评价分级（GRADE）工具评估证据的确定性，并以证据图的形式可视化地呈现结果。结果纳入的36个SR/ ma共涉及3种中医非药物疗法（即针灸、推拿和中医运动）和中草药（CHM）。AMSTAR 2结果显示，20个SR/ ma具有高或中等的方法学质量，而其余研究的方法学质量较低或极低。证据图显示，高质量的SR/MAs支持针灸、推拿按摩、中医锻炼对整体睡眠质量的影响，同时针灸、推拿按摩和中医锻炼也能改善焦虑和抑郁。此外，针灸和推拿按摩可能改善客观结果，如多导睡眠图参数和5-羟色胺水平。结论针刺、推拿按摩和中医操能有效改善整体睡眠质量和情绪结局，并对客观睡眠参数有潜在影响。有足够的证据表明，几种中药配方可以改善睡眠质量。然而，SR/MAs的方法学质量需要进一步提高。协议注册普洛斯普洛斯，CRD42022347769。

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引用次数: 0

Efficacy of herbal medicine (Thatbunjob) in the treatment of foodborne illness: A placebo-controlled, randomized trial 草药（Thatbunjob）治疗食源性疾病的疗效：一项安慰剂对照的随机试验

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-05-25 DOI: 10.1016/j.imr.2025.101153

Jaiboonya Jaicharoensub , Sumalee Panthong , Intouch Sakpakdeejaroen , Thanee Eiamsitrakoon , Patommatat Bhanthumkomol

Background

Foodborne illness (FI) causes 600 million cases and 420,000 deaths annually. Current treatments focus on rehydration and antispasmodic medications for managing dehydration and abdominal pain (AP). However, alternative therapies, especially those derived from natural ingredients, are needed. This study investigates the potential efficacy of herbal medicine,Thatbunjob as a complementary therapy for FI-related AP.

Methods

A double-blind, randomized, placebo-controlled clinical trial assessed the efficacy of Thatbunjob in relieving AP in FI patients. A total of 114 patients, aged 18–60, with AP and diarrhea (≥3 episodes in 24 h), received either two 500 mg capsules of Thatbunjob or a placebo three times daily for three days. Both groups also received standard oral rehydration therapy. Primary outcomes included AP intensity using a visual analog scale (VAS) at 24 h, while secondary outcomes included pain at 48 and 72 h, responder rates, hyoscine butyl bromide usage, stool frequency, and adverse events.

Results

The Thatbunjob group showed significantly greater reduction in AP compared to the placebo. VAS scores decreased from 5.69 to 2.95 at 24 h (P < 0.001), and pain relief persisted at 48 (1.43 vs. 3.05, P < 0.001) and 72 h (0.32 vs. 1.86, P < 0.001). Thatbunjob also reduced the need for hyoscine tablets and decreased stool frequency compared to placebo.

Conclusion

This study demonstrates that Thatbunjob, when combined with standard rehydration therapy, effectively alleviates AP and reduces stool frequency in FI patients.

Trial registration

Thai Clinical Trials Registry, TCTR20220823001.

食源性疾病（FI）每年造成6亿例病例和42万人死亡。目前的治疗重点是补液和抗痉挛药物治疗脱水和腹痛（AP）。然而，需要替代疗法，特别是那些从天然成分中提取的疗法。本研究探讨了草药Thatbunjob作为FI相关AP的补充疗法的潜在疗效。方法采用双盲、随机、安慰剂对照临床试验评估Thatbunjob缓解FI患者AP的疗效。114例患者，年龄18-60岁，伴有AP和腹泻（24小时内≥3次发作），每日3次，服用两次500 mg Thatbunjob胶囊或安慰剂，连续3天。两组患者均接受标准的口服补液治疗。主要结果包括24 h时视觉模拟量表（VAS）的AP强度，次要结果包括48和72 h时的疼痛、反应率、丁基溴的使用、大便频率和不良事件。结果与安慰剂组相比，Thatbunjob组的AP明显减少。24 h时VAS评分由5.69降至2.95 (P <；0.001)，疼痛缓解持续为48 (1.43 vs. 3.05, P <；0.001)和72 h (0.32 vs. 1.86, P <；0.001)。与安慰剂相比，这项研究还减少了对海莨菪碱片的需求，并减少了大便频率。结论本研究表明，bunjob联合标准补液治疗可有效缓解FI患者的AP并减少大便频率。试验注册泰国临床试验注册中心，TCTR20220823001。

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引用次数: 0

Herbal decoctions for dysmenorrhea under universal health coverage pilot project: Evidence from a nationwide claims database in the Republic of Korea 全民健康覆盖试点项目下治疗痛经的草药煎剂：来自大韩民国全国索赔数据库的证据

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-05-21 DOI: 10.1016/j.imr.2025.101152

Kyeore Bae , Minjung Park , Junhyeok Yi

Background

Despite its high prevalence, dysmenorrhea is an underestimated gynecological disorder. To enhance the service coverage, the Pilot Project for Expanding National Health Insurance (NHI) Coverage to Herbal Decoctions (HDs) was implemented in the Republic of Korea from November 2020. This study aimed to assess the effectiveness and safety of HDs for dysmenorrhea at a nationwide level. Additionally, its impact on accessibility was explored.

Methods

This retrospective observational study used claims data from the pilot project (November 1, 2020, to April 28, 2024). A linear mixed-effects model was used to estimate symptom improvement during the HD exposure period. Time series data decomposition and structural change points detection were performed using NHI statistics on dysmenorrhea patient counts for those who received medical services between 2014 and 2023.

Results

Among 39,574 participants, a descriptive analysis of 7016 suggested a tendency to receive HD treatment for moderate-to-severe symptoms. Effectiveness analysis demonstrated that HD significantly reduced symptom severity over time (β = –0.072, p < 0.001). Adverse events were reported by 0.58 % of the patients, mostly involving gastrointestinal symptoms. Following the initiation of the pilot project, a significant increase in the number of patients with dysmenorrhea receiving traditional Korean medicine (TKM) services was observed.

Conclusion

The nationwide pilot project showed clinical effectiveness and a manageable safety profile of HDs for dysmenorrhea. The universal health coverage initiative appeared to have improved the accessibility of TKM services for managing dysmenorrhea. Further robust research utilizing nationwide real-world data is required to validate these findings.

背景：尽管痛经的发病率很高，但它是一种被低估的妇科疾病。为扩大服务覆盖面，自2020年11月起，韩国实施了将国民健康保险（NHI）覆盖面扩大到草药煎剂（HDs）的试点项目。本研究的目的是在全国范围内评估HDs治疗痛经的有效性和安全性。此外，还探讨了其对可达性的影响。方法回顾性观察研究使用试点项目（2020年11月1日至2024年4月28日）的索赔数据。使用线性混合效应模型来估计HD暴露期间症状的改善情况。对2014 - 2023年接受医疗服务的痛经患者数量进行NHI统计，进行时间序列数据分解和结构变化点检测。结果在39,574名参与者中，对7016名参与者的描述性分析表明，他们倾向于在中度至重度症状时接受HD治疗。有效性分析显示，随着时间的推移，HD显著降低了症状严重程度(β = -0.072, p <；0.001)。有0.58%的患者报告了不良事件，主要涉及胃肠道症状。试点项目启动后，观察到接受韩国传统医学服务的痛经患者人数显著增加。结论hdd治疗痛经的临床效果良好，安全性可控。全民健康覆盖倡议似乎改善了治疗痛经的TKM服务的可及性。需要进一步利用全国实际数据进行强有力的研究来验证这些发现。

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引用次数: 0

Effect of acupoint catgut embedding for simple obesity in adults: A randomized controlled double-blind trial 穴位埋线治疗成人单纯性肥胖：一项随机对照双盲试验

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-05-14 DOI: 10.1016/j.imr.2025.101151

Qiwang Yang , Nenggui Xu , Lidong Guo , Hui Li , Xiaoyan Li , Qingmei Zeng , Wenyue Zhang , Shiping Li , Wei Yi

Background

Acupoint catgut embedding (ACE) is considered an effective treatment for simple obesity, though high-quality clinical evidence remains lacking. To establish a solid evidence base in obesity management, well-designed studies are needed to verify both the short- and long-term efficacy and safety of ACE.

Methods

In this randomized controlled, double-blind trial, 120 patients with simple obesity were initially allocated to verum ACE (n = 60) or sham ACE group (n = 60) .One participant allocated to the verum group was excluded during screening for failing to meet BMI criteria (<24 kg/m²), resulting in a final cohort of 59 verum and 60 sham cases completing the 12-week intervention and 12-week follow-up. The primary outcome was the change in body weight from baseline to week 12. Secondary outcomes included body weight change at 12-week follow-up, cumulative weight change by week 24, changes in body mass index (BMI), body fat status, body circumference, and appetite indicators.

Results

After the 12-week treatment, both groups showed varying degrees of weight loss, with the verum ACE group experiencing a significantly greater reduction compared to the sham group. At the 12-week follow-up, the visceral fat grade of the verum group was significantly greater than that of sham group. The waist, upper arm, and thigh girths in the verum group decreased significantly more than that in sham group; the reduction degree of waist-hip ratio was significantly better than that in the sham group at all time points. Additionally, the cumulative reduction in appetite factors was significantly higher in the verum group compared to the sham group.

Conclusion

ACE can significantly reduce body weight, and is both long-lasting and safe. It also has beneficial effects on fat distribution, body circumference, and appetite, making it a promising complementary therapy for simple obesity.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2100046693.

穴位埋线（ACE）被认为是治疗单纯性肥胖的有效方法，但仍缺乏高质量的临床证据。为了在肥胖管理中建立坚实的证据基础，需要精心设计的研究来验证ACE的短期和长期疗效和安全性。方法在本随机对照双盲试验中，120例单纯性肥胖患者最初被分配到verum ACE组（n = 60）和sham ACE组（n = 60），其中verum组1例因BMI不符合标准（24 kg/m²）而被排除，最终有59例verum和60例sham患者完成了12周的干预和12周的随访。主要结局是体重从基线到第12周的变化。次要结局包括随访12周时的体重变化、第24周时的累计体重变化、体重指数（BMI）、体脂状况、体围和食欲指标的变化。结果治疗12周后，两组患者均出现不同程度的体重减轻，其中verum ACE组的体重减轻幅度明显大于sham组。随访12周，肺脏脂肪分级明显高于假手术组。髋部组大鼠腰部、上臂、大腿围围较假手术组明显减小；各时间点腰臀比减小程度均明显优于假手术组。此外，与假药组相比，verum组的食欲因素累积减少量明显更高。结论ace能显著降低体重，且长效、安全。它还对脂肪分布、体围和食欲有有益的影响，使其成为单纯性肥胖的一种有希望的补充疗法。中国临床试验注册中心，ChiCTR2100046693。

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引用次数: 0

Evaluating and ranking guidelines on traditional and integrative medicine globally: Establishment of the International STAR-TIM Committee 全球传统医学和中西医结合指南的评估和排名：国际STAR-TIM委员会的建立

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-05-04 DOI: 10.1016/j.imr.2025.101150

Xuan Yu , Yishan Qin , Janne Estill , Hui Liu , Xu Wang , Zhaoxiang Bian , Yaolong Chen , on behalf of STAR Secretariat

To further enhance the quality and transparency of practice guidelines and consensus statements, the Scientific, Transparent, and Applicable Rankings (STAR) working group was officially established and commenced its work in 2021. The STAR tool contains 39 items grouped into 11 domains, with each domain and item assigned to a weight that reflects its importance. In 2021–2022, a total of 266 Chinese Traditional and Integrative Medicine (TIM) guidelines and consensus statements met the inclusion criteria for STAR evaluation. After evaluating these TIM guidelines and consensus statements, the highest STAR score achieved was 96.5 (out of 100), with a median score 23.3 and a mean score of 32.0. As the number of TIM guidelines and consensus statements published globally continues to increase, the STAR Secretariat aims to establish an International STAR Specialty Committee for TIM. Utilizing the integrated STAR evaluation system and large language models, the committee seeks to enhance the efficiency of evaluations without compromising accuracy. This initiative aims to conduct evaluations of international TIM guidelines and consensus statements, thereby improving their quality and transparency. Additionally, it will assess the importance and necessity of developing the International STAR-TIM Extension.

为进一步提高实践指南和共识声明的质量和透明度，科学、透明和适用排名（STAR）工作组于2021年正式成立并开始工作。STAR工具包含分为11个领域的39个项目，每个领域和项目分配一个反映其重要性的权重。在2021-2022年，共有266份中医与中西医结合（TIM）指南和共识声明符合STAR评估的纳入标准。在评估这些TIM指南和共识声明后，STAR得分最高达到96.5（满分100分），中位数得分为23.3，平均得分为32.0。随着全球出版的TIM指南和协商一致声明的数量不断增加，STAR秘书处的目标是为TIM建立一个国际STAR专业委员会。委员会利用综合STAR评价系统和大型语言模型，力求在不损害准确性的情况下提高评价的效率。这项倡议旨在对国际TIM准则和协商一致声明进行评价，从而提高其质量和透明度。此外，它将评估发展国际STAR-TIM扩展的重要性和必要性。

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引用次数: 0

Acupuncture and moxibustion in integrative oncology and new progress in China 针灸在中西医结合肿瘤学研究中的新进展

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-04-24 DOI: 10.1016/j.imr.2025.101149

Ming Yang , Yue Chen , Yuxiang Wan , Chen Shen , Jinchang Huang

Acupuncture and moxibustion are increasingly gaining recognition in the clinical and research fields of integrative oncology. This review synthesizes findings from clinical guidelines, systematic reviews, meta-analyses, and randomized controlled trials (RCTs) of acupuncture and moxibustion for cancer care. Clinical evidence highlights acupuncture’s efficacy in managing symptoms such as hot flashes, pain, insomnia, fatigue, and constipation. Acupuncture also demonstrates potential effects in reducing chemotherapy and radiotherapy-induced side effects. Recent advancements in China shows integrated therapies combining acupuncture with chemotherapy to enhance therapeutic outcomes. Additionally, laboratory studies reveal the potential of acupuncture and moxibustion to modulate the tumor microenvironment, boost chemotherapy efficacy, and strengthen immunity. Despite these promising results, there is a pressing need for well-designed trials and real-world studies to evaluate the long-term effects of standardized acupuncture and moxibustion treatments in cancer care.

针灸在综合肿瘤学的临床和研究领域越来越受到重视。本综述综合了针灸治疗癌症的临床指南、系统综述、荟萃分析和随机对照试验（rct）的研究结果。临床证据强调针灸在治疗诸如潮热、疼痛、失眠、疲劳和便秘等症状方面的功效。针灸在减少化疗和放疗引起的副作用方面也显示出潜在的作用。中国最近的进展表明，针灸与化疗相结合的综合疗法可以提高治疗效果。此外，实验室研究揭示了针灸在调节肿瘤微环境、提高化疗疗效和增强免疫方面的潜力。尽管有这些令人鼓舞的结果，但迫切需要精心设计的试验和现实世界的研究来评估标准化针灸治疗在癌症治疗中的长期效果。

引用次数: 0

Comparative effectiveness and safety of acupuncture vs metformin in insulin-resistant polycystic ovary syndrome women: A network meta-analysis of RCTs 针灸与二甲双胍治疗胰岛素抵抗型多囊卵巢综合征的疗效和安全性比较：随机对照试验的网络荟萃分析

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-04-23 DOI: 10.1016/j.imr.2025.101148

Wen-Li Yan , Zun-Qi Kan , Li-Qiong Wang , Zhen-Ping Yu , Cun-Zhi Liu , Shi-Yan Yan , Na-Na Yang

Background

The purpose of this study was to conduct a network meta-analysis (NMA) comparing the effectiveness and safety of traditional acupuncture with metformin. This study aims to identify an effective and safe alternative treatment for women with polycystic ovary syndrome (PCOS) complicated by insulin resistance (IR).

Methods

We searched PubMed, EMBASE, Web of Science, Cochrane, ClinicalTrials.gov, and relevant citations for eligible randomized controlled trials (RCTs) published up to August 12, 2024. Data extraction and bias assessment were performed by two independent reviewers, and Bayesian NMA was performed using the GeMTC package, with a random effects model. The NMA compared the effectiveness and safety of acupuncture with metformin which were measured using the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) index, fasting plasma glucose, fasting insulin, and the incidence of adverse events (AEs).

Results

We included 12 RCTs (n = 870). Four RCTs compared acupuncture with metformin, six compared metformin with control interventions (blank control or placebo), and two compared acupuncture with sham acupuncture. Acupuncture (Mean difference (MD): -0.76, 95 % credible interval (CrI): -1.42, -0.03) and metformin (MD: -0.74, 95 % CrI: -1.28, -0.17) significantly reduced the IR level (HOMA-IR). No statistical difference was observed between both treatment methods in improving glucose metabolism; however, acupuncture had fewer AEs (risk ratio: 0.13, 95 % CrI: 0.01, 0.68). Acupuncture all ranked high in terms of surface under the cumulative ranking curve across all outcomes, thus demonstrating better effectiveness and safety potential.

Conclusions

Acupuncture may be a potential alternative for PCOS women with IR, as it is equally effective, easier to perform, and relatively safer than metformin. Further trials are necessary to confirm these findings owing to the current lack of sufficient evidence.

Protocol registration: PROSPERO, CRD42024581934.

本研究的目的是通过网络荟萃分析（NMA）比较传统针灸与二甲双胍的有效性和安全性。本研究旨在为多囊卵巢综合征（PCOS）合并胰岛素抵抗（IR）的女性寻找一种有效且安全的替代治疗方法。方法检索PubMed、EMBASE、Web of Science、Cochrane、ClinicalTrials.gov以及截至2024年8月12日发表的符合条件的随机对照试验（RCTs）的相关引文。数据提取和偏倚评估由两名独立审稿人进行，贝叶斯NMA使用GeMTC软件包，采用随机效应模型。NMA通过稳态模型评估胰岛素抵抗（HOMA-IR）指数、空腹血糖、空腹胰岛素和不良事件（ae）发生率来比较针灸与二甲双胍的有效性和安全性。结果纳入12项rct （n = 870）。4项随机对照试验比较针灸与二甲双胍，6项比较二甲双胍与对照干预（空白对照或安慰剂），2项比较针灸与假针灸。针刺（平均差值（MD）： -0.76, 95%可信区间（CrI）： -1.42, -0.03）和二甲双胍(MD: -0.74, 95%可信区间（CrI: -1.28, -0.17）显著降低IR水平（HOMA-IR）。两种治疗方法在改善糖代谢方面无统计学差异；而针灸的不良事件发生率较低（危险比：0.13,95% CrI: 0.01, 0.68）。针刺在所有结局的累积排名曲线下均排名较高，显示出更好的疗效和安全潜力。结论针刺治疗与二甲双胍相比，具有同样的疗效、操作简单且相对安全的优点，可能是PCOS合并IR患者的潜在替代方法。由于目前缺乏足够的证据，需要进一步的试验来证实这些发现。协议注册：PROSPERO， CRD42024581934。

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引用次数: 0

Patient Experiences of Integrative health CarE [PEICE]: A cross-sectional study 综合医疗护理的患者体验[PEICE]：一项横断面研究

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-04-23 DOI: 10.1016/j.imr.2025.101147

Matthew J Leach , Simon DuBois , Reine DuBois

Background

Although consumer demand and practitioner interest in integrative health care (IHC) have amplified over the past few decades, the patient experience of IHC still remains poorly understood. This study aimed to explore patient’s experiences of receiving care within an IHC setting in Australia.

Methods

Adults that had accessed an IHC setting within the past 12 months were invited to participate in a national, cross-sectional study. Individuals meeting the inclusion criteria were asked to complete the 57-item Integrative Healthcare Experience Tool (iHEET), online.

Results

A total of 327 participants completed the iHEET (82.3 % female; 92.9 % aged 30 years or older). Participants reported a generally favourable experience of IHC, as indicated by an overall IHC experience score of 4.19 ± 0.90 (mean ± SD). Mean experience subscores were high for 8 of the 12 IHC experience domains (i.e. respectful, personalised, patient-centred, holistic, interdisciplinary, evidence-based, communicative, wellness-focussed), and moderate for 4 of the 12 domains (i.e. non-hierarchical, collaborative, coordinated, accessible).

Conclusion

The findings of this novel study suggest IHC practice in Australia closely aligns with the philosophy and framework of IHC, and is mostly congruent with what patients want from an IHC service. Notwithstanding, there are several areas where IHC services could improve in order to optimise the patient experience. These areas include providing care that is more visibly collaborative and coordinated, and enabling equitable access to services for diverse patient populations.

虽然在过去的几十年里，消费者的需求和从业者对综合医疗保健（IHC）的兴趣已经扩大，但患者对综合医疗保健的体验仍然知之甚少。本研究旨在探讨患者在澳大利亚的IHC环境中接受护理的经历。方法：在过去12个月内接受过免疫组化治疗的成年人被邀请参加一项全国性的横断面研究。符合纳入标准的个人被要求在线完成包含57个项目的综合医疗体验工具（iHEET）。结果共327名参与者完成了iHEET，其中女性占82.3%；92.9%年龄在30岁或以上)。参与者报告了总体良好的免疫组化体验，总体免疫组化体验得分为4.19±0.90（平均±SD）。12个IHC体验领域中的8个（即尊重、个性化、以患者为中心、整体、跨学科、以证据为基础、沟通、健康为重点）的平均体验子得分较高，12个领域中的4个（即无等级、协作、协调、可访问）的平均体验子得分中等。结论：这项新研究的结果表明，澳大利亚的免疫结合实践与免疫结合的理念和框架密切相关，并且与患者对免疫结合服务的需求基本一致。尽管如此，为了优化患者体验，免疫健康服务仍有几个领域有待改进。这些领域包括提供更加明显的协作和协调的护理，并使不同的患者群体能够公平地获得服务。

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引用次数: 0

A nationwide retrospective cohort study of the association between acupuncture exposure and clinical outcomes of idiopathic Parkinson’s disease using health insurance claim data in South Korea 一项使用韩国健康保险索赔数据的针灸暴露与特发性帕金森病临床结果之间关系的全国性回顾性队列研究

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-04-22 DOI: 10.1016/j.imr.2025.101146

Ye-Chae Hwang , Jungkuk Lee , Dongwoo Kang , Han-Gyul Lee , Seungwon Kwon , Seung-Yeon Cho , Seong-Uk Park , Woo-Sang Jung , Sang-Kwan Moon , Jung-Mi Park , Jungtae Leem , Chang-Nam Ko

Background

Idiopathic Parkinson’s disease (IPD) has been associated with increased global mortality. While acupuncture has been reported to slow IPD progression, its effect on mortality remains unclear. This study investigated the association between acupuncture exposure and mortality, causes of death, and prognosis in patients with IPD.

Methods

Using customized cohort data from the National Health Insurance Service (NHIS), we analyzed patients newly diagnosed with IPD without disabilities between 2012 and 2016. Patients were classified into an acupuncture group (≥six sessions within 1 year of diagnosis) and a non-acupuncture group. Propensity score matching (PSM) was applied, and Cox proportional hazards models were used for survival analysis. During a 6-year follow-up, hazard ratios (HRs) were estimated for overall and cause-specific mortality, emergency room visits, fractures, and the first deep brain stimulation (DBS) procedure, using the non-acupuncture group as the reference.

Results

After PSM, 6394 patients were included in each group. The HR for mortality in the acupuncture group was 0.887 (95 % CI: 0.813−0.967), indicating a significantly lower mortality risk. Deaths due to neoplasms and digestive diseases were also lower in the acupuncture group. No significant differences were observed between groups in fracture risk, emergency room visits, or DBS procedures.

Conclusions

Acupuncture exposure was associated with a reduced mortality rate in patients with IPD. These findings suggest potential benefits of integrating acupuncture into IPD management, though further long-term randomized controlled trials are needed to confirm these results.

背景：帕金森病（IPD）与全球死亡率增加有关。虽然有报道称针灸可以减缓IPD的进展，但其对死亡率的影响尚不清楚。本研究调查了针刺暴露与IPD患者死亡率、死亡原因和预后之间的关系。方法使用国民健康保险服务（NHIS）定制队列数据，分析2012年至2016年新诊断的无残疾IPD患者。患者分为针灸组（诊断1年内≥6次）和非针灸组。采用倾向评分匹配（PSM）， Cox比例风险模型进行生存分析。在6年的随访中，以非针灸组为参照，估计了总体和原因特异性死亡率、急诊室就诊、骨折和第一次深部脑刺激（DBS）手术的风险比（hr）。结果经PSM治疗后，每组共纳入6394例患者。针刺组死亡率HR为0.887 (95% CI: 0.813 ~ 0.967)，死亡率风险明显降低。因肿瘤和消化系统疾病导致的死亡率在针灸组也较低。在骨折风险、急诊室就诊或DBS手术方面，两组间未观察到显著差异。结论针刺暴露与IPD患者死亡率降低相关。这些发现表明将针灸纳入IPD治疗的潜在益处，尽管需要进一步的长期随机对照试验来证实这些结果。

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引用次数: 0

Comparative efficacy of moxibustion in chemotherapy-induced leukopenia: A Bayesian network meta-analysis 艾灸治疗化疗性白细胞减少的比较疗效：贝叶斯网络荟萃分析

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2025-04-15 DOI: 10.1016/j.imr.2025.101145

Zun-Yuan Li , Chun-Lan Chen , Xiao-Yan Li , Wen-Ge Huo , Yan Yang , Yu-Hong Guo , Zhi-Dan Liu

Background

Moxibustion has been applied in various clinical treatments, including chemotherapy-induced leukopenia. Using a Bayesian network meta-analysis, this study assessed a wide range of published data to identify the most efficient and effective method of moxibustion therapy for treating chemotherapy-induced leukopenia.

Methods

PubMed, EMBASE, and eight other databases plus two clinical trial registration platforms were searched from their respective inception date to January 2024. All randomized controlled trials (RCTs) of moxibustion for chemotherapy-induced leukopenia were included. The primary outcome indicator was white blood cell count, and the secondary outcome was the Karnofsky performance status score. Stata (version 17.0) and the gemtc package (version 1.0–0) of R (version 4.3.1) were used to perform the network meta-analysis. This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number CRD42023402588.

Results

Thirty RCTs with 2282 total patients involving 12 types of moxibustion-related therapies were identified. Results of the surface under the cumulative ranking curve revealed the following treatments as most effective for leukopenia: thunder-fire moxibustion combined with medication (95.9 %), grain-sized moxibustion combined with medication (76.2 %), and herb-separated moxibustion (76.0 %). Grain-sized moxibustion combined with medication (76.5 %) ranked first in improving Karnofsky performance status scores.

Conclusion

Thunder-fire moxibustion combined with medication appears to be the most effective treatment for chemotherapy-induced leukopenia.

Protocol registration

PROSPERO, CRD42023402588.

背景艾灸已被应用于各种临床治疗，包括化疗引起的白细胞减少症。使用贝叶斯网络荟萃分析，本研究评估了大量已发表的数据，以确定艾灸治疗化疗引起的白细胞减少症的最有效方法。方法检索spubmed、EMBASE等8个数据库及2个临床试验注册平台，检索时间从各自建立日期至2024年1月。所有艾灸治疗化疗所致白细胞减少的随机对照试验（rct）均被纳入。主要结局指标为白细胞计数，次要结局指标为Karnofsky表现状态评分。使用R（4.3.1版本）的Stata（17.0版本）和gemtc包（1.0-0版本）进行网络meta分析。本研究已在普洛斯彼罗（PROSPERO）数据库注册，注册号为CRD42023402588。结果共纳入30项随机对照试验，共2282例患者，涉及12种艾灸相关疗法。累积排序曲线下的表面结果显示，治疗白细胞减少症效果最好的是雷火灸联合用药（95.9%）、颗粒灸联合用药（76.2%）和隔药灸（76.0%）。颗粒化艾灸联合用药改善Karnofsky表现状态评分排名第一（76.5%）。结论雷火灸联合药物治疗化疗所致白细胞减少症疗效最佳。协议注册普洛斯普洛斯，CRD42023402588。

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