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Dietary Habits of Newly Diagnosed Patients with Breast Cancer in Korea. 韩国新确诊乳腺癌患者的饮食习惯。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-05-01 Epub Date: 2024-01-23 DOI: 10.4082/kjfm.23.0117
Jaehoon Shin, Jiyeon Lee, Yooeun Yoon, Hye Sun Lee, Hyungmi Kim, Yu-Jin Kwon, Ji-Won Lee

Background: In patients with breast cancer, a healthy diet can help reduce breast cancer-specific recurrence, mortality, and comorbid chronic disease rates. There have been few studies on dietary habits immediately after breast cancer diagnosis, especially those involving the Asian population. Therefore, this study aimed to compare the nutritional habits of newly diagnosed patients with breast cancer and the general population without cancer in Korea using propensity score (PS) matching.

Methods: We conducted a case-controlled study of 157 patients with breast cancer and 2,363 cancer-free control participants from the Korea National Health and Nutrition Examination Survey. The PS values for the predicted probability of patients with breast cancer and the general population were estimated using logistic regression analysis, including age and body mass index. The dietary patterns were assessed using a 24-hour recall of 1 day and the Food Frequency Questionnaire.

Results: PS matching showed that patients with breast cancer consumed fewer calories and carbohydrates; however, they consumed more protein and fat compared to the general population. Compared to the general population, patients with breast cancer consumed more healthy foods such as fish, seaweed, vegetables, fruit, mixed-grain rice, and nuts; however, they also consumed more soup, stew, and red meat.

Conclusion: Newly diagnosed patients with breast cancer have some healthy dietary habits compared to the general population. However, there is considerable room for improvement in their diet quality. Our results support the need to develop tailored dietary recommendations for patients with breast cancer during the diagnostic and posttreatment periods to improve their diet quality.

背景:对于乳腺癌患者来说,健康的饮食有助于降低乳腺癌的复发率、死亡率和合并慢性病的发病率。有关乳腺癌确诊后的饮食习惯的研究很少,尤其是涉及亚洲人群的研究。因此,本研究旨在利用倾向得分(PS)匹配法,比较韩国新诊断的乳腺癌患者和未患癌症的普通人群的营养习惯:方法:我们对韩国国民健康与营养调查中的 157 名乳腺癌患者和 2363 名未患癌症的对照人群进行了病例对照研究。采用逻辑回归分析法估算了乳腺癌患者和普通人群的预测概率 PS 值,包括年龄和体重指数。饮食模式通过 1 天 24 小时回忆和食物频率问卷进行评估:PS比对结果显示,乳腺癌患者摄入的热量和碳水化合物较少;但与普通人群相比,他们摄入的蛋白质和脂肪较多。与普通人群相比,乳腺癌患者摄入了更多的健康食品,如鱼、海藻、蔬菜、水果、杂粮米饭和坚果;但他们也摄入了更多的汤、炖肉和红肉:结论:与普通人群相比,新诊断的乳腺癌患者有一些健康的饮食习惯。结论:与普通人相比,新确诊的乳腺癌患者有一些健康的饮食习惯,但他们的饮食质量还有很大的提高空间。我们的研究结果表明,有必要为乳腺癌患者在诊断期和治疗后制定有针对性的饮食建议,以改善他们的饮食质量。
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引用次数: 0
Clinical Applicability of Machine Learning in Family Medicine. 机器学习在全科医学中的临床应用。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-05-01 Epub Date: 2024-05-20 DOI: 10.4082/kjfm.45.3E
Jungun Lee
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引用次数: 0
Shared Decision-Making Training in Family Medicine Residency: A Scoping Review. 全科住院医生共同决策培训:范围审查。
IF 1.4 Q4 PRIMARY HEALTH CARE Pub Date : 2024-05-01 Epub Date: 2024-05-20 DOI: 10.4082/kjfm.23.0273
Apichai Wattanapisit, Eileen Nicolle, Savithiri Ratnapalan

Shared decisions, in which physicians and patients share their agendas and make clinical decisions together, are optimal for patient-centered care. Shared decision-making (SDM) training in family medicine residency is always provided, but the best training approach for improving clinical practice is unclear. This review aims to identify the scope of the literature on SDM training in family medicine residency to better understand the opportunities for training in this area. Four databases (Embase, MEDLINE, Scopus, and Web of Science) were searched from their inception to November 2022. The search was limited to English language and text words for the following four components: (1) family medicine, (2) residency, (3) SDM, and (4) training. Of the 522 unique articles, six studies were included for data extraction and synthesis. Four studies referenced three training programs that included SDM and disease- or condition-specific issues. These programs showed positive effects on family medicine residents' knowledge, skills, and willingness to engage in SDM. Two studies outlined the requirements for SDM training in postgraduate medical education at the national level, and detailed the educational needs of family medicine residents. Purposeful SDM training during family medicine residency improves residents' knowledge, skills, and willingness to engage in SDM. Future studies should explore the effects of SDM training on clinical practice and patient care.

共同决策是指医生和患者分享各自的议程并共同做出临床决策,是以患者为中心的最佳护理方式。全科住院医师培训一直都提供共同决策(SDM)培训,但改善临床实践的最佳培训方法尚不明确。本综述旨在确定有关全科住院医师培训中 SDM 培训的文献范围,以便更好地了解该领域的培训机会。我们检索了四个数据库(Embase、MEDLINE、Scopus 和 Web of Science)从开始到 2022 年 11 月的内容。搜索仅限于英语和以下四个部分的文本词:(1) 全科医学;(2) 住院医师;(3) SDM;(4) 培训。在 522 篇文章中,有 6 项研究被纳入数据提取和综合。四项研究引用了三个培训项目,其中包括 SDM 和疾病或特定病症问题。这些项目对家庭医学住院医生的知识、技能和参与 SDM 的意愿产生了积极影响。两项研究概述了国家级医学研究生教育对 SDM 培训的要求,并详细说明了家庭医学住院医生的教育需求。在全科住院医师培训期间进行有目的的 SDM 培训可提高住院医师的知识、技能和参与 SDM 的意愿。未来的研究应探讨 SDM 培训对临床实践和患者护理的影响。
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引用次数: 0
How to Strengthen Primary Care? The Integration of Clinical Practice and Community Health Care. 如何加强初级保健?临床实践与社区保健相结合。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-05-01 Epub Date: 2024-03-22 DOI: 10.4082/kjfm.23.0242
Erlina Wijayanti
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引用次数: 0
Health Information Quality of Online Newspaper Articles in Korea. 韩国在线报纸文章的健康信息质量。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-07 DOI: 10.4082/kjfm.23.0197
Hangyeol Lee, Seung-Won Oh

Background: The Web is an important source of health information, but the quality of such online information is highly variable. This study evaluates the quality of health articles published on Naver News, Korea's most popular portal, using the Health Information Quality Assessment Tool (HIQUAL).

Methods: We collected 712 health-related articles published on Naver News from May 1 to 7, 2023. After applying exclusion criteria, we selected 116 articles for analysis. Two clinicians independently assessed the quality of these articles using the HIQUAL, which scores articles based on five domains: "reliability," "usefulness," "understandability," "sufficiency," and "transparency."

Results: Overall article quality was generally considered recommendable (mean±standard deviation: 7.52±2.00). "Usefulness," one item of "reliability," and "understandability" were the three items with the highest levels of satisfaction. "Sufficiency" criteria for costs, risks, and benefits received low scores. Quality scores for articles focused on health risk factors and intervention showed a statistically significant difference.

Conclusion: While the overall quality of health information in Korean online newspaper articles is acceptable, room for improvement remains in some areas, particularly with regard to the fair presentation of costs, risks, and benefits. The study highlights the need for ongoing quality improvement and evaluation initiatives for online health information.

背景:网络是健康信息的重要来源,但此类在线信息的质量参差不齐。本研究使用健康信息质量评估工具(HIQUAL)对韩国最受欢迎的门户网站 Naver News 上发表的健康文章的质量进行了评估:我们收集了 2023 年 5 月 1 日至 7 日在 Naver News 上发表的 712 篇健康相关文章。在应用排除标准后,我们选择了 116 篇文章进行分析。两名临床医生使用 HIQUAL 独立评估了这些文章的质量,HIQUAL 根据五个方面对文章进行评分:HIQUAL 根据 "可靠性"、"有用性"、"可理解性"、"充分性 "和 "透明度 "五个方面对文章进行评分:文章的总体质量被普遍认为是值得推荐的(平均值±标准差:7.52±2.00)。"有用性"、一项 "可靠性 "和 "可理解性 "是满意度最高的三个项目。成本、风险和收益的 "充分性 "标准得分较低。以健康风险因素和干预措施为重点的文章的质量得分在统计学上有显著差异:虽然韩国网络报纸文章中健康信息的总体质量可以接受,但在某些方面仍有改进的余地,尤其是在公平介绍成本、风险和益处方面。这项研究强调了对在线健康信息进行持续质量改进和评估的必要性。
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引用次数: 0
Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension. 高血压患者常用护理来源与药物依从性的相关性
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-01 Epub Date: 2023-11-27 DOI: 10.4082/kjfm.23.0125
Han-Kil Kang, Nak-Jin Sung

Background: Maintaining a usual source of care (USC), which is crucial for primary healthcare, encompasses initial contact, comprehensive services, coordinated care, and ongoing support. However, limited research exists on the relationship between USC and medication adherence in patients with hypertension. This study aimed to investigate the association between USC and medication adherence among patients with hypertension.

Methods: Data from the 2nd Korea Health Panel Survey 2020 were analyzed. The final sample consisted of 3,318 participants aged 19 years or older diagnosed with hypertension. USC was categorized into three groups: no USC, place only (without a regular doctor), and regular doctor. Medication adherence was assessed using detailed items (dose, frequency, time, no stop) and a 4-point Likert scale. A logistic regression analysis was conducted with control for relevant variables.

Results: Compared to the no USC group, the regular doctor group had significantly higher odds ratios (ORs) for overall perfect/high medication adherence rates: 1.70 (95% confidence interval [CI], 1.42-2.03) and 1.59 (95% CI, 1.14-2.20). Similar results were observed for each adherence item, including prefect dose (OR, 2.14; 95% CI, 1.73- 2.63), frequency (OR, 1.87; 95% CI, 1.53-2.28), time (OR, 1.72; 95% CI, 1.43-2.07), and no stop (OR, 1.56; 95% CI, 1.09-2.23)/high frequency (OR, 2.47; 95% CI, 1.21-5.01), time (OR, 2.30; 95% CI, 1.19-4.44). However, the place only group showed no significant differences in medication adherence except for perfect adherence to dose (OR, 1.35; 95% CI, 1.06-1.71).

Conclusion: These findings provide evidence supporting the need for healthcare policies that encourage having a regular doctor in South Korea, which has a healthcare system with limited primary care.

背景:维持常规护理来源(USC)对初级卫生保健至关重要,包括初始接触、综合服务、协调护理和持续支持。然而,关于高血压患者USC与药物依从性之间关系的研究有限。本研究旨在探讨高血压患者USC与药物依从性之间的关系。方法:分析2020年第二次韩国健康小组调查的数据。最后的样本包括3318名年龄在19岁或以上的高血压患者。南加州大学被分为三组:没有南加州大学,只有地方(没有常规医生)和常规医生。采用详细项目(剂量、频率、时间、停药)和4点李克特量表评估药物依从性。在控制相关变量的情况下,进行logistic回归分析。结果:与无USC组相比,常规医生组总体完美/高药物依从率的优势比(ORs)显著更高:1.70(95%可信区间[CI], 1.42-2.03)和1.59 (95% CI, 1.14-2.20)。在每个依从性项目中观察到类似的结果,包括完美剂量(OR, 2.14;95% CI, 1.73- 2.63),频率(OR, 1.87;95% CI, 1.53-2.28),时间(OR, 1.72;95% CI, 1.43-2.07),无停止(OR, 1.56;95% CI, 1.09-2.23)/高频(OR, 2.47;95% CI, 1.21-5.01),时间(OR, 2.30;95% ci, 1.19-4.44)。然而,只有地方组在药物依从性方面没有显着差异,除了完全依从剂量(OR, 1.35;95% ci, 1.06-1.71)。结论:这些发现提供了证据,支持韩国鼓励有正规医生的医疗保健政策的必要性,韩国的医疗保健系统初级保健有限。
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引用次数: 0
A Rare Presentation of Probable Training-Related Chronic Myopericarditis in an Endurance Cyclist: A Case Report. 一名耐力自行车运动员罕见的可能与训练有关的慢性心肌炎:病例报告。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-01 Epub Date: 2024-02-14 DOI: 10.4082/kjfm.23.0082
Azwan Aziz Mohamad, Nahar Azmi Mohamed

We report a rare case of high-volume training-related myopericarditis. A male, 18 years old, elite road bicycle racing cyclist with high-volume training of 1,000 km per week for >7 years, presented with progressively worsening exertional breathlessness, reduced effort tolerance, and one episode of cardiac syncope. The symptoms were present prior to the coronavirus disease 2019 pandemic but made worse with the sudden increase in the volume of training after lockdown periods in preparation for competition. He exhibited multiple premature ventricular ectopic beats during his resting electrocardiogram, with a normal echocardiogram and non-elevated cardiac enzyme. The exercise stress test revealed similar multiple premature ventricular beats, warranting further investigation using cardiac magnetic resonance imaging (MRI). The findings of the cardiac MRI were suggestive of myopericarditis. He was instructed to refrain from training and initially started with a short course of colchicine. However, his symptoms deteriorated, and cardiac MRI revealed a decrease in the left ventricular ejection fraction from 59% to 50%. His treatment was escalated to a short course of tapered dose steroid, anti-failure medication and gradual, supervised, return to sports program. This case report highlights the discussion of return to play in athletes with myopericarditis.

我们报告了一例罕见的与大运动量训练相关的心肌炎病例。一名 18 岁的男性精英公路自行车赛自行车运动员在超过 7 年的时间里每周进行 1,000 公里的大运动量训练,表现为逐渐加重的劳累性呼吸困难、耐受力下降和一次心脏性晕厥。这些症状在冠状病毒病 2019 年大流行之前就已出现,但在为比赛做准备的封闭期之后,训练量突然增加,导致症状加重。他在静息心电图中表现为多次室性早搏,超声心动图正常,心肌酶未升高。运动负荷试验也发现了类似的多发性室性早搏,因此需要使用心脏磁共振成像(MRI)进行进一步检查。心脏磁共振成像的结果提示他患有心肌炎。医生嘱咐他不要进行训练,并开始短期服用秋水仙碱。然而,他的症状恶化了,心脏磁共振成像显示左心室射血分数从59%下降到50%。他的治疗升级为短程减量类固醇和抗心衰药物治疗,并在监督下逐步恢复运动。本病例报告重点讨论了患有心肌炎的运动员重返赛场的问题。
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引用次数: 0
Association of Primary Care Physician Supply with Population Mortality in South Korea: A Pooled Cross-Sectional Analysis. 韩国初级保健医生供应与人口死亡率的关系:综合横断面分析》。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-01 Epub Date: 2024-01-30 DOI: 10.4082/kjfm.23.0156
Hyeonseok Koh, Soonman Kwon, Belong Cho

Background: Primary care physicians perform a comprehensive role by providing continuous, patient-centered, and accessible healthcare and establishing connections with specialized care. However, the association between the supply of primary care physicians and mortality rates in South Korea has not been thoroughly investigated.

Methods: This study utilized data from 229 si-gun-gu in South Korea from 2016 to 2020. The densities of primary care physicians, physicians in functional primary clinics, specialists in primary care facilities, and active physicians per 100,000 people were independent variables. Age-adjusted all-cause mortality and cause-specific mortality rates per 100,000 individuals were the dependent variables. Negative binomial regression, negative binomial regression with a pseudo-panel approach, and geographically weighted regression were used to analyze the data.

Results: Our study revealed a significant negative association between the density of primary care physicians and all-cause mortality. An increase in a primary care physician per 100,000 population was significantly linked to a 0.11% reduction in all-cause mortality (incidence rate ratio, 0.9989; 95% confidence interval, 0.9983-0.9995). Similar associations have been observed between mortality rates owing to cardiovascular diseases, respiratory tract diseases, and traffic accidents.

Conclusion: This study provides evidence that having a higher number of primary care physicians in South Korea is associated with lower mortality rates. Future research should consider better indicators that reflect the quality of primary care to better understand its impact on population health outcomes. These findings emphasize the significance of strengthening primary care in the South Korean healthcare system to improve the overall health and wellbeing.

背景:初级保健医生通过提供持续的、以患者为中心的、便捷的医疗保健服务,并与专科医疗机构建立联系,发挥着综合作用。然而,在韩国,初级保健医生的供应与死亡率之间的关系尚未得到深入研究:本研究利用了韩国 229 个郡区在 2016 年至 2020 年期间的数据。每 10 万人中的全科医生、功能性基层诊所医生、全科医疗机构中的专科医生和在职医生的密度是自变量。因变量为每 10 万人中经年龄调整后的全因死亡率和特定病因死亡率。数据分析采用了负二项回归法、伪面板法负二项回归法和地域加权回归法:我们的研究表明,全科医生密度与全因死亡率之间存在明显的负相关。每 10 万人中初级保健医生的增加与全因死亡率降低 0.11% 有显著联系(发病率比为 0.9989;95% 置信区间为 0.9983-0.9995)。心血管疾病、呼吸道疾病和交通事故死亡率之间也存在类似的联系:本研究提供的证据表明,在韩国,初级保健医生人数越多,死亡率越低。未来的研究应考虑更好的指标,以反映初级保健的质量,从而更好地了解其对人口健康结果的影响。这些发现强调了在韩国医疗保健系统中加强初级保健以改善整体健康和福祉的重要性。
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引用次数: 0
Low Muscle Strength as Risk Factor for Non-Alcoholic Fatty Liver Disease in Different Metabolic Conditions. 低肌力是不同代谢条件下非酒精性脂肪性肝病的危险因素。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-01 Epub Date: 2023-11-28 DOI: 10.4082/kjfm.23.0118
Hye-Sun Rho, Whan-Seok Choi

Background: Non-alcoholic fatty liver disease (NAFLD) recently became a leading liver disease that threatens health worldwide. Low muscle strength, obesity, insulin resistance, and metabolic syndrome are recognized key factors for NAFLD. However, the impact of low muscle strength itself in different metabolic conditions has not been widely studied.

Methods: A cross-sectional analysis was performed of a sample of 5,427 participants from the 2019 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (rHGS, defined as handgrip strength/body mass index) was used to assess muscle strength. The cut-off values for a low rHGS were 1.405 for men and 0.850 for women. NAFLD was diagnosed if the Hepatic Steatosis Index was >36. Participants were stratified according to insulin resistance, metabolic syndrome, and central obesity for the subgroup analyses.

Results: Complex sample multivariate logistic regression analysis revealed a significant association between low muscle strength and NAFLD after the adjustment for other confounders (odds ratio [OR], 1.92; P<0.001). In the insulin resistance, metabolic syndrome, and central obesity subgroups, a significant association between low muscle strength and NAFLD remained (OR, 1.66-4.19 depending on subgroup; all P<0.05), whereas it did not in the no central obesity group.

Conclusion: This study demonstrated that low muscle strength is correlated with a risk of NAFLD. This relationship was independent of insulin resistance and metabolic syndrome but was dependent on the presence of central obesity.

背景:非酒精性脂肪性肝病(NAFLD)最近成为威胁全球健康的主要肝脏疾病。低肌力、肥胖、胰岛素抵抗和代谢综合征是公认的NAFLD的关键因素。然而,低肌力本身在不同代谢条件下的影响尚未得到广泛研究。方法:对2019年韩国国家健康与营养检查调查的5427名参与者进行横断面分析。相对握力(rHGS,定义为握力/体重指数)用于评估肌肉力量。低rHGS的临界值男性为1.405,女性为0.850。肝脂肪变性指数>36时诊断为NAFLD。根据胰岛素抵抗、代谢综合征和中心性肥胖对参与者进行亚组分析。结果:复杂样本多因素logistic回归分析显示,校正其他混杂因素后,低肌力与NAFLD之间存在显著关联(优势比[OR], 1.92;结论:本研究表明,低肌力与NAFLD的风险相关。这种关系与胰岛素抵抗和代谢综合征无关,但依赖于中枢性肥胖的存在。
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引用次数: 0
Effect of Curcumin on Dysmenorrhea and Symptoms of Premenstrual Syndrome: A Systematic Review and Meta-Analysis. 姜黄素对痛经和经前综合征症状的影响:系统回顾与元分析》。
IF 2.3 Q4 PRIMARY HEALTH CARE Pub Date : 2024-03-01 Epub Date: 2024-01-24 DOI: 10.4082/kjfm.23.0184
Foruzan Sharifipour, Shahla Faal Siahkal, Kowsar Qaderi, Zeynab Mohaghegh, Maryam Zahedian, Faeze Azizi

Background: Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of life. The present study examined the effects of curcumin on the severity of dysmenorrhea and PMS symptoms.

Methods: A systematic review and meta-analysis of randomized controlled trials was conducted by searching databases such as the Cochrane Library, EMBASE, Scopus, PubMed, and Web of Science from inception to January 2023. Article screening was performed using Endnote ver. X8 (Clarivate). Review Manager (RevMan ver. 5.3; Cochrane) was used for the quality assessment and meta-analysis. A total of 147 studies were screened, of which five were finally selected for quantitative and qualitative analyses. The studies were conducted between 2015 and 2021, and a total of 379 participants with a mean age of 23.33±5.54 years had been recruited in these studies.

Results: The meta-analysis showed that curcumin consumption could significantly reduce the severity of dysmenorrhea (mean difference, -1.25; 95% confidence interval [CI], -1.52 to -0.98; three studies; I2=31%) and the overall score of PMS (standardized mean difference, -1.41; 95% CI, -1.81 to -1.02; two studies; I2=0%).

Conclusion: The reduction in the severity of PMS and dysmenorrhea has been attributed to curcumin's anti-inflammatory and antidepressant activities. Although the findings suggest that curcumin may be an effective treatment for reducing the severity of PMS and dysmenorrhea, further research with a larger number of participants from various socioeconomic levels and a longer duration of treatment is needed to evaluate the effective dose of curcumin.

痛经和经前综合征(PMS)是育龄妇女常见的周期性和多发性并发症,会对健康和生活质量造成负面影响。本研究探讨了姜黄素对痛经和经前综合征症状严重程度的影响。本研究通过检索 Cochrane Library、EMBASE、Scopus、PubMed 和 Web of Science 等数据库,对从开始到 2023 年 1 月的随机对照试验进行了系统综述和荟萃分析。文章筛选使用 Endnote ver.X8 (Clarivate)进行文章筛选。在进行质量评估和荟萃分析时,使用了 Review Manager (RevMan ver. 5.3; Cochrane)。共筛选出 147 项研究,最终选择其中 5 项进行定量和定性分析。这些研究在 2015 年至 2021 年间进行,共招募了 379 名参与者,平均年龄(23.33±5.54)岁。荟萃分析表明,服用姜黄素能显著降低痛经的严重程度(平均差,-1.25;95% 置信区间[CI],-1.52 至-0.98;3 项研究;I2=31%)和经前期综合征的总分(标准化平均差,-1.41;95% CI,-1.81 至-1.02;2 项研究;I2=0%)。经前期综合征和痛经严重程度的降低归因于姜黄素的抗炎和抗抑郁活性。尽管研究结果表明姜黄素可能是减轻经前综合征和痛经严重程度的有效治疗方法,但还需要对更多来自不同社会经济水平的参与者和更长的治疗时间进行进一步研究,以评估姜黄素的有效剂量。
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引用次数: 0
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Korean Journal of Family Medicine
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