Journal of alternative and complementary medicine最新文献

Objective: Diabetes mellitus and dyslipidemia are currently increasing dramatically, and conventional medicine in the treatment of them has limited efficacies and serious adverse effects. Pluchea indica (L.) Less. tea (PIT) is widely consumed as a health-promoting drink in Southeast Asia. This study aimed to investigate whether P. indica tea has antidyslipidemic and antihyperglycemic effects and toxicity in humans. Design: A randomized clinical trial. Setting/Location: Nakhonratchasima, Thailand. Participants: Forty-five participants with prediabetes. Interventions: Participants were randomized to receive placebo tea, 1.5 g of PIT, and 1.5 g Camellia sinensis tea (green tea, CST) once daily for 12 weeks. Outcome Measurements: The oral glucose tolerance test (OGTT), total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood urea nitrogen (BUN), creatinine, alanine transaminase (ALT), alkaline phosphatase (ALP), and complete blood count (CBC) before and after treatment were investigated. Results: The results showed that PIT significantly ameliorated hyperglycemia and significantly lower serum TG (109.22 ± 5.21 mg/dL) and LDL-C (122.20 ± 3.67 mg/dL) than placebo (145.56 ± 8.18 and 142.07 ± 8.58 mg/dL, respectively) (p < 0.05). Moreover, PIT exhibited serum TG (109.22 ± 5.21 mg/dL) significantly lower than CST (124.38 ± 4.70 mg/dL) (p < 0.05). In addition, the serum HDL-C of PIT (57.56 ± 3.05 mg/dL) was significantly higher than the placebo (46.44 ± 2.47 mg/dL) (p < 0.05). Furthermore, the toxicity testing showed that no significant difference in BUN, creatinine, ALT, ALP, and CBC of PIT-treated group compared with the placebo (p > 0.05). Conclusions: These results suggest that PIT may ameliorate hyperglycemia and dyslipidemia in prediabetes people. It may not be toxic to the kidney, liver, and blood. So, PIT has the potential to develop to be a health-promoting tea or herbal medicine for hyperglycemia and dyslipidemia prevention.

Introduction: Within family medicine it is generally accepted that the more we know about patients' lives, the better the care we provide. Few studies have sought to quantify this historical assumption. We wondered if knowing their chronic pain, patients' life stories would improve the physician-patient relationship in a family medicine residency training program clinic. Methods: We selected patients in chronic pain with depression and/or anxiety who were considered difficult. After a lead in period to establish stability of ratings, we obtained a life story interview for 125 such patients after administering the doctor-patient relationship questionnaire to them and their physicians. Patients completed the McGill Pain Inventory (MPQ), the Zung Anxiety Inventory, and the Center for Epidemiological Studies Depression Scale. Physicians completed the Jefferson Physicians Empathy Scale. Questionnaires were repeated every 4 months. Results: The quality of the physician-patient relationship increased significantly over the course of the year for patients (increase of 0.60, standard deviation [SD] = 0.13, 95% confidence interval [CI] = 0.57 to 0.63, p < 0.001) and for doctors (increase of 0.77, SD = 0.20, 95% CI = 0.72 to 0.81, p < 0.001). The perceived level of pain on the MPQ decreased significantly on the sensory component (71.2 ± 7.6 to 11.7 + 9.4, 95% CI = 0.589 to 9.411, p = 0.0270 and the affective component (4.2 + 3.4 to 2.1 + 4.3, 95% CI = 0.131 to 4.069, p = 0.037). Anxiety and depression ratings did not change. Physicians' empathy ratings increased significantly over the course of the year from a mean of 117.2 (SD = 10.2) to 125.1 (SD = 16.1) for a difference of 7.90, which was significant at p = 0.0273 with a 95% CI of -14.85 to -0.915. Discussion: Knowing the patient's life story improves the physician-patient relationship for both patients and physicians. When the physician-patient relationship improves, the perceived level of pain decreases. Physicians' empathy ratings increase. While the interview requires 90-120 min, it is billable, and can be done by medical students, medical assistants, social workers, or behavioral health. Conclusions: Obtaining life stories of chronic pain patients is a cost-effective way to reduce pain while simultaneously improving the physician-patient relationship and increasing physician empathy.

Objectives: This study describes the development and feasibility of Integrative Nutritional Counseling (INC), a Chinese medicine (CM)+biomedicine-based nutrition curriculum for Chinese Americans with type 2 diabetes. Although Chinese Americans often incorporate CM principles into their diet, scant research has explored how to integrate CM with biomedical nutrition standards in a culturally appropriate manner or if such a program could improve diabetes self-management. Design: This is a 1-month pre-post study design including three points of contact: baseline, in-person class, and 1-month follow-up. Subjects: Participants (n = 15) were Cantonese-speaking/reading Chinese Americans diagnosed with type 2 diabetes who had used some form of CM/medicinal foods in the last 12 months. Interventions and Outcome Measures: The INC program included baseline surveys and a CM intake interview conducted by a licensed acupuncturist. The acupuncturist generated a CM diagnosis, which was shared with the participant, and used this diagnosis to tailor brief nutrition education. To bolster this brief education, a bilingual registered dietitian provided a 2-h group education class in Cantonese to all participants, during which time participants also received a Chinese/English INC booklet. Participants completed surveys immediately after the class and at 1-month follow-up, with qualitative exit interviews. Results: Participants reported improved attitudes and dietary habits aligning directly with INC, and improvement in biomedically valued measures of type 2 diabetes, such as weight loss, and CM-valued measures of digestion/elimination and hot/cold feeling. Satisfaction with INC was high, but challenges included confusion with some INC information, structural barriers, and comorbidities. Conclusions: Chinese Americans with type 2 diabetes and interventionists found integrative nutrition approaches acceptable and feasible. Future research should examine INC with a larger population and explore optimal delivery of INC given reported challenges.

Objectives: Although Baduanjin (a traditional Chinese physical activity) has been reported to promote general health, the optimal exercise intensity and kinematic characteristics of this intervention remain poorly understood. This investigation aimed to quantify and compare the exercise intensities of traditional standing Baduanjin (TB) and sitting Baduanjin (SB) using cardiopulmonary exercise testing, to further clarify the sources of the previously observed benefits of this modality. Study design: Observational study. Interventions: Healthy individuals were recruited to perform TB, SB, and cycling (in order) until they reached their ventilatory threshold. Intensity-relevant parameters based on type of exercise and specific time points (exercise start and the end of the 2nd, 4th, 6th, and 8th set of motion) were compared between TB and SB with ventilatory threshold as control. Results: Forty individuals (18 male and 22 female) completed the trial. Significant differences in peak oxygen uptake, metabolic equivalent of task, and Borg scale existed among the three exercise types, indicating a decreasing overall exercise intensity in the order of ventilatory threshold, TB, and SB. All parameters except the respiratory exchange ratio fluctuated significantly across the time points. Conclusions: Both TB and SB resulted in a significantly lower exercise intensity when compared with the ventilatory threshold established through cycling exercise. The benefits of Baduanjin might be explained partly by its appropriate exercise intensity and intermittent intensity pattern. Baduanjin might be a potential alternative to existing schemes for exercise rehabilitation.

Objective: We aimed to study the short-term effects of Integrated Amrita Meditation (IAM) technique in anxiety and depression states and to have a better understanding on the underlying physiological changes related to short-term and long-term IAM practice. Design: Short-term IAM practitioners (ST-IAM) and long-term IAM practitioners (LT-IAM) were compared to control groups of the same age and naïve to yoga and meditation (ST-control and LT-control, respectively). Settings/Location: Kerala, India. Subjects: People that did not suffer from any major medical condition. All participants were naïve to yoga and meditation practices, except for the 5 LT-IAM practitioners. Intervention: ST-IAM practitioners underwent 2 community IAM practices and 5 individual IAM practices. LT-IAM practitioners (performing IAM regularly for more than 4 years) underwent a community IAM practice before the study. Outcome measures: Anxiety and depression states and physiological parameters from ST-IAM and ST-control groups were assed in two different visits (before and after the week of IAM practice or control condition). LT-IAM and LT-control subjects' physiological measurements were taken in only one visit. Results: Short-term IAM practice significantly decreased anxiety and depression states; two way ANOVA indicated differences on anxiety and depression scores across visits between ST-IAM and ST-control groups (Group effect: F_{(1, 25)} = 6.083, p = 0.0209; F_{(1, 25)} = 4.449, p = 0.0451). However, no changes were observed on their physiological parameters (heart rate, blood pressure, oxygen saturation, and dopamine and GABA plasma levels). Interestingly, LT-IAM practitioners showed increased GABA plasma levels than the LT-control group (p = 0.0358, t = 2.521, df = 8). Conclusions: Our study indicates the possible role of IAM technique on modulations of the plasma GABAergic levels and shows that one week of IAM practice is accompanied by a significant decrease of anxiety and depression states in the healthy population.

Objectives: Plantar heel pain (PHP) is the most common cause of heel pain and can be debilitating; 20% of patients are refractory to standard of care. The Fascial Distortion Model (FDM), a novel manual diagnostic and treatment strategy, is purported to be effective for chronic pain; however, no rigorous studies document its effectiveness. We assessed the FDM for care of PHP. Design: Single arm prospective effectiveness study. Settings/Location: Outpatient primary care clinic; Fort Gordon, GA. Subjects: Outpatient adults. Interventions: Participants received an FDM-informed diagnostic and treatment strategy to identify fascial "distortions" at the foot based on patient-reported pain patterns and palpatory examination and then to provide distortion-specific manual therapy at baseline and 1 week. Outcome Measures: Primary outcome measure (0, 1, and 16 weeks): the Foot Pain subscale on the validated Foot Health Status Questionnaire (FHSQ; 0-100 points on each of eight separate subscales); secondary outcome measures (0, 1, and 16 weeks): the seven remaining subscales on the FHSQ, visual analog pain scale (VAS, 0-100 points), and plantar fascia thickness of the most effected foot assessed by ultrasound (0 and 16 weeks). Analysis was performed per protocol using repeated-measures analysis of variance. Results: One hundred and ninety-seven participants were screened; 33 were enrolled. Twenty-eight participants received two FDM procedures. Compared with baseline, improvement on the FHSQ Foot Pain (33.8-23.6 points) and Foot Function (23.9-19.8 points) subscales and VAS (44.7-27.7 points) at 16 weeks was statistically significant (all p's < 0.001) and clinically important representing large effect sizes. Relative to baseline, 16-week ultrasound demonstrated reduced average plantar fascia thickness (0.6-0.9 mm [p = 0.001]). Demographic characteristics were unrelated to response. Satisfaction was high. There were no serious adverse events; side effects included consistent mild-to-moderate self-limited pain. Conclusions: Participants with PHP who received FDM-informed care reported significant and sustained improvement on validated foot pain and foot function measures; additional findings included decreased plantar fascial thickness. These results require corroboration in a larger randomized controlled study. Clinical Trial Registration No: DDEAMC17005.

Objectives: This study aims to describe the characteristics of published peer-reviewed journal articles authored by naturopathic practitioners (NPs) Design: The study used bibliometric analysis of data extracted from journal articles. Settings/Location: International Subjects: Articles were included if they had at least one author with a naturopathic qualification and were published in a peer-reviewed, indexed journal. Data collection: A snowballing method was used between June 2018 and July 2019 to identify relevant articles. Outcome measures: Data related to geography, affiliation, year of publication, article type or research design, article topic, and journal were extracted from each included article. Results: Identified articles (n = 2,218) were published by NP from 22 countries between 1987 and 2019, with 80.9% published in the last 10 years. Most articles were published by NP from the America (52.5%) and Western Pacific (28.3%) World Health Organization regions. The most common type of study design or article type was reviews and meta-analyses (23.2%) and clinical trials or intervention studies (19.4%). Explicit mention of naturopathy was reported in 8.1% of articles. Almost half (48.4%) of all included articles were published in 40 journals, and 56.9% of these were published in journals ranked in the first quartile of at least one subject area. Articles focused on mental health were more likely to be conducted in Australia (odds ratio [OR] 3.3) and focused on lifestyle behavior (OR 2.5) or clinical nutrition (OR 1.6). Articles about cancer or cancer-related conditions were more likely to include lifestyle behavior (OR 2.0) and less likely to be conducted in Australia (OR 0.1) or Germany (OR 0.5). Conclusions: The international naturopathy research community has produced peer-reviewed literature for over 30 years and has demonstrated sustained commitment to codifying existing knowledge, generating new knowledge, and disseminating this knowledge to the wider clinical and research community.