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Therapeutic Fasting as a Novel Approach to Mitigate Musculoskeletal Symptoms in Breast Cancer Patients undergoing Aromatase Inhibitor Therapy: A Feasibility Study Protocol. 治疗性禁食作为缓解芳香酶抑制剂治疗乳腺癌患者肌肉骨骼症状的新方法:可行性研究方案
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2026-01-01 Epub Date: 2026-03-10 DOI: 10.1177/15347354261426272
Henriette Meyer, Daniela A Koppold, Osaid Shaker, Laura Eden, Lisa Schiffmann, Stefan Konigorski, Holger Cramer, Kyung-Eun Anna Choi, Hermann Einsele, Marcela Winkler, Claudia Löffler
<p><strong>Introduction: </strong>Aromatase inhibitor-induced musculoskeletal symptoms (AIMSS) or aromatase inhibitor-induced arthralgia (AIA), common side effects of long-term adjuvant endocrine therapy for breast cancer patients, can significantly affect quality of life. Preliminary clinical evidence suggests that fasting may alleviate these symptoms, as demonstrated in conditions such as rheumatoid arthritis and fibromyalgia. This study aims to evaluate the feasibility and acceptability of prolonged therapeutic fasting program, including structured behavioral and educational support, in patients with AIMSS/AIA and explore the applicability of validated measurement tools for assessing symptom burden in preparation for a confirmatory bicentric trial.</p><p><strong>Methods: </strong>This is a bicentric, single-arm, prospective pilot study. We will enroll 54 participants undergoing endocrine therapy with aromatase inhibitors who suffer from AIMSS/AIA. All participants will receive a 7-day online- prolonged therapeutic fasting intervention (max. 350 kcal/day), consisting of vegetable juices and broths under medical supervision. The primary outcome is the feasibility of prolonged therapeutic fasting during aromatase inhibitor therapy assessed through participant adherence to the fasting protocol and completion rate. As a secondary endpoint, we will assess the feasibility of using validated measurement instruments to collect data on symptoms, quality of life, mindfulness, stress, and sleep quality in preparation for a confirmatory trial. The following well established tools will be used: Numeric Rating Scale (NRS), Visual Analog Scale (VAS), Brief Pain Inventory (BPI), Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire-Disability Index (HAQ-DI), WHO-5 Well-Being Index (WHO-5), Mindful Attention Awareness Scale (MAAS), Brief Fatigue Inventory (BFI) and Pittsburgh Sleep Quality Index (PSQI). Specifically, we aim to explore their applicability by evaluating completion rates, participant acceptability, and data completeness within this patient population. Exploratory parameters, including changes in dietary habits, anthropometric data, and cancer-related fatigue will be tracked to contextualize the feasibility findings and inform outcome selection for a future confirmatory trial. An accompanying N-of-1 trial using a mobile application (StudyU) and qualitative interviews will give more insight into individual and subjective changes.</p><p><strong>Conclusion: </strong>If the intervention proves feasible and well accepted, these findings will support the development of a confirmatory trial designed to investigate the potential clinical benefits and underlying mechanisms of fasting in AIMSS/AIA. Long-term studies incorporating biomarkers and microbiota analysis could further explore the mechanisms underlying symptom improvement and guide personalized treatment strategies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov.NCT
简介:芳香酶抑制剂诱导的肌肉骨骼症状(AIMSS)或芳香酶抑制剂诱导的关节痛(AIA)是乳腺癌患者长期辅助内分泌治疗的常见副作用,可显著影响生活质量。初步临床证据表明,禁食可以缓解这些症状,如类风湿关节炎和纤维肌痛。本研究旨在评估AIMSS/AIA患者长期禁食治疗方案的可行性和可接受性,包括结构化的行为和教育支持,并探讨有效测量工具在评估症状负担方面的适用性,为验证性双中心试验做准备。方法:这是一项双中心、单臂、前瞻性先导研究。我们将招募54名患有AIMSS/AIA的患者接受芳香酶抑制剂内分泌治疗。所有参与者将接受为期7天的在线延长治疗性禁食干预。350千卡/天),包括在医生监督下的蔬菜汁和肉汤。主要结果是在芳香酶抑制剂治疗期间延长治疗性禁食的可行性,通过参与者对禁食方案的依从性和完成率进行评估。作为次要终点,我们将评估使用经过验证的测量仪器收集症状、生活质量、正念、压力和睡眠质量数据的可行性,为验证性试验做准备。将使用以下完善的工具:数字评定量表(NRS),视觉模拟量表(VAS),简短疼痛量表(BPI),纤维肌痛影响问卷(FIQ),健康评估问卷-残疾指数(HAQ-DI), WHO-5幸福指数(WHO-5),正心注意力意识量表(MAAS),简短疲劳量表(BFI)和匹兹堡睡眠质量指数(PSQI)。具体来说,我们的目标是通过评估完成率、参与者可接受性和该患者群体的数据完整性来探索其适用性。探索性参数,包括饮食习惯的变化、人体测量数据和癌症相关疲劳,将被跟踪,以确定可行性研究结果的背景,并为未来验证性试验的结果选择提供信息。使用移动应用程序(StudyU)和定性访谈进行的N-of-1试验将更深入地了解个人和主观的变化。结论:如果干预被证明是可行的,并且被广泛接受,这些发现将支持开展一项验证性试验,旨在研究AIMSS/AIA中禁食的潜在临床益处和潜在机制。结合生物标志物和微生物群分析的长期研究可以进一步探索症状改善的机制,并指导个性化的治疗策略。试验注册:ClinicalTrials.gov.NCT06172088。2023年12月14日注册。URL: https://clinicaltrials.gov/study/NCT06172088。
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引用次数: 0
The Definition Dilemma of Fuzheng-Based Therapy in NSCLC Systematic Reviews and a Proposal for a Dual-Anchor Model. 非小细胞肺癌系统评价中扶正治疗的定义困境及双锚模型的提出
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2026-01-01 Epub Date: 2026-02-04 DOI: 10.1177/15347354251414648
Xiaoyu Han, Yujin Liu
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引用次数: 0
Comment on "Efficacy of Chinese Medicine on Postoperative Rehabilitation of Non-Small Cell Lung Cancer (NSCLC), a Randomized Controlled Study". 《中医药对非小细胞肺癌(NSCLC)术后康复疗效的随机对照研究》评议
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2026-01-01 Epub Date: 2026-02-05 DOI: 10.1177/15347354261420552
Xiaojie Zhou, Junlei Chen, Yuying Li, Yin Fu
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引用次数: 0
Effectiveness of Acupuncture and Moxibustion for Non-Small Cell Lung Cancer (NSCLC) Patients Undergoing Standard Treatment: A Systematic Review and Meta-Analysis. 针灸治疗非小细胞肺癌(NSCLC)患者的疗效:系统评价和荟萃分析。
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2026-01-01 Epub Date: 2026-02-19 DOI: 10.1177/15347354261419716
Dong-Hyeon Kim, Mi-Sun Park, Keon-Jun Lee, Jong-Ha Kwon, Ye-Jin Jin, So-Jung Park

Background: Lung cancer is the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for 80% to 85% of cases. While surgery and chemotherapy are primary treatments, their side effects-such as nausea, vomiting, and immunosuppression-significantly impact quality of life (QoL). Acupuncture and moxibustion, commonly used in Traditional Asian Medicine (TAM), are proposed to alleviate these effects, though their efficacy in NSCLC remains uncertain. This systematic review and meta-analysis evaluated their impact on QoL, chemotherapy-induced nausea and vomiting (CINV), and immune function in NSCLC patients.

Methods: Nine databases (PubMed, Embase, Cochrane Library, CNKI, OASIS, ScienceON, KISS, KMBASE, and RISS) were searched for randomized controlled trials (RCTs) published until April 2025. RCTs comparing acupuncture or moxibustion with standard care in NSCLC patients were included. Primary outcomes were QoL (QLQ-C30, KPS); secondary outcomes included CINV and immune markers (CD3, CD4, CD8, CD4/CD8 ratio, TNF-α). Data were analyzed using Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB tool.

Results: Thirty-nine RCTs (N = 3610) were included. Acupuncture and moxibustion significantly improved QoL (QLQ-C30 MD = 12.39; KPS MD = 8.22; both P < .00001), reduced CINV incidence (RR = 0.32, P < .00001), and enhanced symptom relief (RR = 1.16, P < .00001). Immune function markers, including CD3 (MD = 7.20, P = .0002), CD4 (MD = 4.89, P = .0003), and the CD4/CD8 ratio (MD = 0.22, P < .00001), were significantly increased, while TNF-α levels decreased (MD = -11.05, P = .04).

Conclusion: Acupuncture and moxibustion improve QoL, reduce CINV, and modulate immune function in NSCLC, supporting their complementary role.

背景:肺癌是癌症相关死亡的主要原因,非小细胞肺癌(NSCLC)占病例的80% ~ 85%。虽然手术和化疗是主要的治疗方法,但它们的副作用——如恶心、呕吐和免疫抑制——会显著影响生活质量(QoL)。针刺和艾灸,在传统亚洲医学(TAM)中常用,被认为可以减轻这些影响,尽管它们对非小细胞肺癌的疗效尚不确定。本系统综述和荟萃分析评估了它们对非小细胞肺癌患者生活质量、化疗引起的恶心和呕吐(CINV)和免疫功能的影响。方法:检索9个数据库(PubMed、Embase、Cochrane Library、CNKI、OASIS、ScienceON、KISS、KMBASE和RISS),检索截至2025年4月发表的随机对照试验(RCTs)。纳入了比较针刺或艾灸与非小细胞肺癌患者标准治疗的随机对照试验。主要指标为生活质量(QoL) (QLQ-C30, KPS);次要结局包括CINV和免疫标志物(CD3、CD4、CD8、CD4/CD8比值、TNF-α)。使用Review Manager 5.4分析数据,使用Cochrane RoB工具评估偏倚风险。结果:共纳入39项rct (N = 3610)。针灸可显著改善QoL (QLQ-C30 MD = 12.39; KPS MD = 8.22;两者P P P P P =。0002), cd4 (md = 4.89, p =。0003)和CD4 / CD8比值(MD = 0.22, P P = .04点)。结论:针灸改善非小细胞肺癌患者的生活质量,降低CINV,调节免疫功能,支持二者的互补作用。
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引用次数: 0
The Stress Process and Well-Being in Breast Cancer: The Mediating Role of Hope and Zest. 乳腺癌患者的应激过程与幸福感:希望和热情的中介作用。
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 Epub Date: 2025-11-21 DOI: 10.1177/15347354251396665
Lorena M Soria-Reyes, M Victoria Cerezo, Aline T Polak, María J Blanca

The extent to which breast cancer impacts well-being depends on the patient's psychosocial resources for coping with the stressors the illness entails. Recent research has shown that character strengths, such as hope and zest, play a role in the life satisfaction of breast cancer patients, although the underlying mechanisms are yet to be explored. This study, involving 173 Spanish women with breast cancer, analyses the mediating role of hope and zest in the association between illness-specific stressors and 2 indicators of well-being, namely life satisfaction and flourishing. Both hope and zest were positively correlated with life satisfaction and flourishing, and negatively with stressors. Mediation analysis revealed that the relationship between stressors and the 2 indicators of well-being is mediated by both these character strengths. These results suggest that a lack of hope and zest is one mechanism through which stress may diminish well-being, whereas high levels of these character strengths may buffer the impact of stressors and improve well-being in breast cancer patients. Psycho-oncologists are encouraged to develop effective psychological interventions to promote these strengths in women with breast cancer.

乳腺癌对健康的影响程度取决于患者应对疾病带来的压力的社会心理资源。最近的研究表明,性格优势,如希望和热情,在乳腺癌患者的生活满意度中发挥着作用,尽管潜在的机制还有待探索。这项研究涉及173名西班牙乳腺癌妇女,分析了希望和热情在疾病特异性压力源与2个幸福指标(即生活满意度和繁荣)之间的关联中的中介作用。希望和热情都与生活满意度和繁荣呈正相关,与压力源负相关。中介分析表明,压力源与幸福感的关系均受性格优势的中介作用。这些结果表明,缺乏希望和热情是压力可能降低幸福感的一种机制,而高水平的这些性格优势可能会缓冲压力源的影响,提高乳腺癌患者的幸福感。鼓励心理肿瘤学家开发有效的心理干预措施,以促进乳腺癌妇女的这些优势。
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引用次数: 0
Response to Thanchonnang et al - From Efficacy to Implementation - Critical Insights for Clinical Practice. 对Thanchonnang等人的回应-从疗效到实施-临床实践的关键见解。
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 Epub Date: 2025-12-23 DOI: 10.1177/15347354251410184
Severin Schricker, Felix Breßmer, Mark Dominik Alscher, Claudia Löffler, Holger Cramer, Marcela Winkler
{"title":"Response to Thanchonnang et al - From Efficacy to Implementation - Critical Insights for Clinical Practice.","authors":"Severin Schricker, Felix Breßmer, Mark Dominik Alscher, Claudia Löffler, Holger Cramer, Marcela Winkler","doi":"10.1177/15347354251410184","DOIUrl":"10.1177/15347354251410184","url":null,"abstract":"","PeriodicalId":13734,"journal":{"name":"Integrative Cancer Therapies","volume":"24 ","pages":"15347354251410184"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retraction Notice: Dihydromyricetin Exhibits Antitumor Activity in Nasopharyngeal Cancer Cell Through Antagonizing Wnt/β-Catenin Signaling. 撤回声明:二氢杨梅素通过拮抗Wnt/β-Catenin信号通路在鼻咽癌细胞中显示抗肿瘤活性。
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 Epub Date: 2025-07-28 DOI: 10.1177/15347354251364601
{"title":"Retraction Notice: Dihydromyricetin Exhibits Antitumor Activity in Nasopharyngeal Cancer Cell Through Antagonizing Wnt/β-Catenin Signaling.","authors":"","doi":"10.1177/15347354251364601","DOIUrl":"10.1177/15347354251364601","url":null,"abstract":"","PeriodicalId":13734,"journal":{"name":"Integrative Cancer Therapies","volume":"24 ","pages":"15347354251364601"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Intracranial Progression-Free Survival in Lung Cancer Brain Metastases Extended Beyond 50 Months with Gubenxiaoyi Formula (GBXY): A Groundbreaking Case Study. 固本消益方(GBXY)治疗50个月以上肺癌脑转移患者的长期颅内无进展生存期:一个开创性的案例研究
IF 2.9 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 DOI: 10.1177/15347354241313334
Zhengzheng Yang, Haiming Li, Lei Chen, Shujiao Li, Dong Chen, Taicheng Lu, Tongjing Ding, Ruiyang Han, Peiyu Cheng, Xiaomin Wang

Background: The prevalence of brain metastases (BM) in lung cancer patients is notably high and is associated with poor prognoses. The efficacy of standard treatment regimens in improving intracranial progression-free survival (IPFS) for lung cancer BM is markedly limited. While traditional Chinese medicine (TCM) has been effective in enhancing the quality of life and prognosis of lung cancer patients, its efficacy in treating BM remains unreported.

Case presentation: Here, we present a case of a middle-aged female with lung cancer BM, whose condition was assessed as progressive post-standard treatment including two local surgeries (both involving resection of cerebellar space-occupying lesions), stereotactic radiotherapy, chemotherapy and EGFR-TKIs. Subsequently, she underwent treatment with the traditional Chinese herbal formula gubenxiaoyi (GBXY). The patient was treated with GBXY for a total duration of 55 months. After treatment, a significant reduction of about 50% in intracranial lesions was observed, accompanied by an extension of both Intracranial Progression-Free Survival (IPFS) and Cognitive Deterioration-Free Survival (CDFS) exceeding 50 months.

Conclusion: These results demonstrate that in patients with lung cancer brain metastases (BM) unresponsive to standard treatments, GBXY not only has the potential to effectively prolong IPFS and decelerate cognitive decline, but may also contribute to a reduction in intracranial tumor burden. This suggests that GBXY could be a promising therapeutic option that warrants further investigation.

背景:肺癌患者脑转移(BM)的患病率非常高,并且与预后不良有关。标准治疗方案在改善肺癌BM的颅内无进展生存期(IPFS)方面的疗效明显有限。虽然中药在改善肺癌患者的生活质量和预后方面是有效的,但其治疗BM的疗效尚未见报道。病例介绍:在这里,我们报告了一例中年女性肺癌BM,其病情评估为进行性标准后治疗,包括两次局部手术(均涉及小脑占位性病变切除),立体定向放疗,化疗和EGFR-TKIs。随后,她接受中药固本消益(GBXY)治疗。患者接受GBXY治疗共55个月。治疗后,观察到颅内病变显著减少约50%,并伴有颅内无进展生存期(IPFS)和无认知恶化生存期(CDFS)延长超过50个月。结论:这些结果表明,在标准治疗无效的肺癌脑转移(BM)患者中,GBXY不仅有可能有效延长IPFS和减缓认知能力下降,而且可能有助于减少颅内肿瘤负担。这表明GBXY可能是一种有前景的治疗选择,值得进一步研究。
{"title":"Long-Term Intracranial Progression-Free Survival in Lung Cancer Brain Metastases Extended Beyond 50 Months with Gubenxiaoyi Formula (GBXY): A Groundbreaking Case Study.","authors":"Zhengzheng Yang, Haiming Li, Lei Chen, Shujiao Li, Dong Chen, Taicheng Lu, Tongjing Ding, Ruiyang Han, Peiyu Cheng, Xiaomin Wang","doi":"10.1177/15347354241313334","DOIUrl":"10.1177/15347354241313334","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of brain metastases (BM) in lung cancer patients is notably high and is associated with poor prognoses. The efficacy of standard treatment regimens in improving intracranial progression-free survival (IPFS) for lung cancer BM is markedly limited. While traditional Chinese medicine (TCM) has been effective in enhancing the quality of life and prognosis of lung cancer patients, its efficacy in treating BM remains unreported.</p><p><strong>Case presentation: </strong>Here, we present a case of a middle-aged female with lung cancer BM, whose condition was assessed as progressive post-standard treatment including two local surgeries (both involving resection of cerebellar space-occupying lesions), stereotactic radiotherapy, chemotherapy and EGFR-TKIs. Subsequently, she underwent treatment with the traditional Chinese herbal formula gubenxiaoyi (GBXY). The patient was treated with GBXY for a total duration of 55 months. After treatment, a significant reduction of about 50% in intracranial lesions was observed, accompanied by an extension of both Intracranial Progression-Free Survival (IPFS) and Cognitive Deterioration-Free Survival (CDFS) exceeding 50 months.</p><p><strong>Conclusion: </strong>These results demonstrate that in patients with lung cancer brain metastases (BM) unresponsive to standard treatments, GBXY not only has the potential to effectively prolong IPFS and decelerate cognitive decline, but may also contribute to a reduction in intracranial tumor burden. This suggests that GBXY could be a promising therapeutic option that warrants further investigation.</p>","PeriodicalId":13734,"journal":{"name":"Integrative Cancer Therapies","volume":"24 ","pages":"15347354241313334"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trichosanthes kirilowii Maxim. and Bioactive Compound Cucurbitacin D Alleviate Cisplatin-Induced Peripheral Neuropathy In Vitro and In Vivo. Trichosanthes kirilowii Maxim。和生物活性化合物葫芦素D减轻顺铂诱导的周围神经病变。
IF 2.9 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 Epub Date: 2025-05-18 DOI: 10.1177/15347354251339121
Sooyeon Kang, Gaeun Choi, Daeun Kim, Hogeol Kim, Chunhoo Cheon, Seong-Gyu Ko

Chemotherapy-induced peripheral neuropathy (CIPN) has a markedly deleterious impact on a patient's quality of life. It manifests as pain, paresthesia, numbness, and weakness, particularly in the context of cisplatin (CDDP), a widely utilised chemotherapeutic agent renowned for its pronounced peripheral nerve toxicity. Trichosanthes kirilowii Maxim. (Cucurbitaceae, TK) and cucurbitacin D(CucD), its bioactive compound, have been demonstrated to possess anti-tumour, anti-inflammatory, and antioxidant properties. However, their potential to alleviate CIPN has not been fully exploredyet. The present study evaluated effectiveness of TK and CucD in mitigating CDDP-induced neuropathic pain using both cellular and animal models. CDDP, TK extracts (TKD and TKE), and CucD dose-dependently reduced viability and apoptosis of PC12 cells. Conversely, pre-treatment with TKD, TKE, and CucD exhibited significant protective effects against CDDP-induced cytotoxicity, preserving cell viability and morphology while enhancing neurite outgrowth. In vivo, administration of CDDP resulted in the development of mechanical allodynia and thermalhyperalgesia in rats. However, treatment with TKD and TKE led to a notable improvement in pain threshold and a reduction in hyperalgesia, while CucD demonstrated less pronounced effects. Although body weight was reduced in the CDDP-treated group, it was not significantly mitigated bytreatments. In conclusion, results of this study indicate that TKD, TKE, and CucD have the potential to alleviate CDDP-induced neuropathic pain by protecting against cell damage, promoting neuriteregeneration, and improving pain responses in animal models. Further investigation into TK and CucD as therapeutic options for managing CIPN is warranted.

化疗引起的周围神经病变(CIPN)对患者的生活质量有明显的有害影响。它表现为疼痛、感觉异常、麻木和虚弱,特别是在顺铂(CDDP)的背景下,顺铂是一种广泛使用的化疗药物,以其明显的周围神经毒性而闻名。Trichosanthes kirilowii Maxim。(Cucurbitaceae, TK)和葫芦素D(CucD),其生物活性化合物,已被证明具有抗肿瘤、抗炎和抗氧化的特性。然而,它们缓解CIPN的潜力尚未得到充分探索。本研究通过细胞和动物模型评估了TK和CucD在缓解cddp诱导的神经性疼痛方面的有效性。CDDP、TK提取物(TKD和TKE)和CucD剂量依赖性地降低PC12细胞的活力和凋亡。相反,TKD、TKE和CucD预处理对cddp诱导的细胞毒性具有显著的保护作用,保持细胞活力和形态,同时促进神经突生长。在体内,给药CDDP导致大鼠机械性异常性痛和热痛觉过敏的发生。然而,TKD和TKE治疗导致疼痛阈值的显着改善和痛觉过敏的减少,而CucD表现出不太明显的效果。虽然cddp治疗组体重减轻,但治疗并未显著减轻。总之,本研究结果表明,在动物模型中,TKD、TKE和CucD有可能通过保护细胞损伤、促进神经细胞再生和改善疼痛反应来减轻cdp诱导的神经性疼痛。进一步研究TK和CucD作为管理CIPN的治疗选择是有必要的。
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引用次数: 0
Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis. 艾灸治疗与传统的中西医结合治疗可能以剂量依赖的方式提高iv期肺腺癌患者的生存率:一项前瞻性观察性倾向评分分析研究。
IF 2.8 3区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-01-01 Epub Date: 2025-06-19 DOI: 10.1177/15347354251342739
Hegen Li, Veronika Lindberg, Lihua Zhu, Xiange Huang, Jiali Feng, Jan P A Baak

Background: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof.

Methods: Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances.

Results: Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival (P < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1-4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all P < .05). Cox regression indicated a dosage-dependent Moxa effect (P = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, P = .01). PSA confirmed results were not due to baseline covariate imbalance.

Conclusions: Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.

背景:25% - 30%的原发性IV期肺腺癌(PUAD-IV)在3个月内死亡。在长时间随访中,许多≥3个月的幸存者存活于疾病(AWD)。铂基化疗(PBC)、酪氨酸激酶抑制剂靶向治疗(TKI-TT)和中药(口服CHM)改善预后。在中国,也使用艾灸治疗(Moxa),但没有预后证据。方法:对412例首次发病连续PUAD-IV表现评分0 ~ 1分的患者进行前瞻性观察Moxa评价,随访3 ~ 120个月。所有患者均接受口服CHM + PBC、TKI-TT或PBC + TKI-TT。在治疗开始时给予Moxa(并最终在随访期间通过从头发展适应)确定的中医证候和症状。生存率采用Kaplan-Meier和Cox回归分析。使用倾向评分分析(PSA)与匹配和逆概率处理加权(IPTW)来调整基线协变量失衡。结果:412例患者中,117例患者未接受Moxa治疗,239例患者接受1 ~ 4次治疗,56例患者在常规治疗的基础上接受bb0 ~ 4次治疗。肿瘤-淋巴结-转移(TNM) IVB期和男性增加了疾病死亡(DOD)风险,而TKI-TT、≥4个化疗周期和Moxa改善了生存(p4 Moxa 40.0个月(均P = 0.0004)。36个月时限制平均生存时间(RMST)优于Moxa+TKI-TT(+6.2个月,P = 0.01)。PSA证实的结果不是由于基线协变量失衡。结论:艾灸可以剂量依赖性地改善经TKI治疗和未经TKI治疗的PUAD-IV患者的生存率。需要随机临床试验(RCT)来证实这一点。
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