Journal of Integrative and Complementary Medicine最新文献

Background: Depression is a common psychiatric disorder that impacts millions globally. Non-pharmacological treatments, such as combining music and exercise therapy, have shown potential as alternatives to medication. This meta-analysis evaluates the impact of integrating music with exercise on depressive symptoms.

Methods: A comprehensive literature search was conducted across multiple databases. Randomized controlled trials of combined music and exercise therapy for patients with mild, moderate, or severe depression were included. Interventions included any exercise paired with music therapy, such as Tai Chi or aerobics. They were compared with the standard of care, a waitlist control group, medication, and monotherapy. A meta-analysis was performed using random-effects models in RevMan 5.4. The standardized mean difference (SMD) was used as a summative measure. The effects of age, type of exercise, and duration of intervention on depression were explored in the subgroup analysis.

Results: Seven randomized controlled trials involving 640 patients with depression were analyzed. Results indicated significant improvement in depressive symptoms (SMD = -0.49, 95% CI: -0.93 to -0.06, p = 0.03). Subgroup analyses showed that music combined with Tai Chi (SMD = -0.96, 95% CI: -1.90 to -0.02, p = 0.04) or aerobic exercise (SMD = -0.60, 95% CI: -0.98 to -0.23, p = 0.001) over 12 weeks (SMD = -0.29, 95% confidence interval (CI): -0.50 to -0.08, p = 0.008) significantly reduced symptoms, especially in patients older than 60 years (SMD = -0.31, 95% CI: -0.61 to -0.01, p = 0.04). It can be suggested that patients with depression better tolerate music combined with exercise therapy. Two studies reported transient fatigue, and no withdrawals occurred due to adverse events.

Conclusions: This meta-analysis suggests that combining music and exercise therapy is effective in reducing depressive symptoms. Combining music with aerobic exercise and tai chi is particularly beneficial for patients over 60 years of age. The quality of the evidence was limited by the heterogeneity and varying risk of bias of the included studies, and caution is warranted.

Aim: Calcaneal spur is a common cause of chronic heel pain and functional disability. This study aimed to evaluate the efficacy and safety of individualized homeopathic (IH) medicines compared to placebo (PL) in managing this condition.

Method: In this double-blind, randomized, PL-controlled trial, 128 participants with chronic heel pain from calcaneal spur were randomly assigned to receive either IH (n = 64) or an identical PL (n = 64) for 6 months. Both groups received standard advice on general management (such as foot exercises and contrast baths). The primary outcome was the change in pain intensity from baseline measured on a 100-mm visual analog scale (VAS). The secondary outcome was the change in lower extremity function measured by the Lower Extremity Functional Scale (LEFS). Outcomes were assessed at baseline, 3 months, and 6 months. Analysis was done using an intention-to-treat approach with a mixed-effects model for repeated measures.

Results: The analysis revealed a statistically significant group × time interaction for VAS pain scores (F-value = 35.12, p < 0.001). At 6 months, the IH group showed a significantly greater mean reduction in pain compared to the PL group (mean difference: -33.28; 95% confidence interval [CI]: -44.3 to -22.2; p < 0.001). Similarly, a significant group × time interaction was observed for LEFS scores (F-value = 33.87, p < 0.001). At 6 months, the IH group had a greater improvement in function (mean difference: 13.78; 95% CI: 9.1-18.4; p < 0.001). Both results were clinically significant. No serious adverse events were reported.

Conclusions: Individualized homeopathy resulted in statistically and clinically significant improvements in pain and function for patients with calcaneal spur compared to PL. These findings suggest that homeopathy may be a viable treatment option for this condition.

Background: Xuebijing injection was approved for treating sepsis; however, the efficacy and safety of Xuebijing injection in population with sepsis need further evaluation. We aimed to evaluate the safety and efficacy of Xuebijing injection on sepsis.

Materials and methods: We searched for potential randomized controlled trials about Xuebijing injection and sepsis from six public databases. Primary outcomes included the 28-day mortality and mortality during treatment. Our secondary outcomes were body temperature, APACHE Ⅱ score, and adverse events or reactions. All data were synthesized by the meta package.

Results: A total of 3007 patients (1551 patients receiving the conventional treatment combined with Xuebijing injection and 1456 patients receiving the conventional treatment only) were included. We found Xuebijing injection reduced the 28-day mortality (risk ratio = 0.69 [0.60-0.78], p < 0.0001), mortality during treatment (risk ratio = 0.74 [0.62-0.88], p = 0.0009), APACHE II score (mean difference = 3.91 [2.45-5.38], p < 0.0001), and body temperature (mean difference = 0.43 [0.31-0.55], p < 0.0001) without obvious adverse events (risk ratio = 0.91 [0.77-1.07], p = 0.2405).

Conclusions: Xuebijing injection is effective and safe for treating sepsis. Additional methodologically sound trials with long-term mortality as an outcome measure could provide further insights into whether Xuebijing injection offers an enhanced therapeutic effect for sepsis.

Purpose: This study aimed to review the literature on the impact of medical cannabis (MC) on the quality of life (QoL) of cancer patients.

Materials and methods: A critical review was conducted using PubMed, Latin American and Caribbean Health Sciences Literature, Scopus, Virtual Health Library, and Embase. The inclusion criteria were access to the full content; in English, Spanish, or Portuguese; published until January 2025, relating "Cancer," "Quality of Life," and "Medical Cannabis." Of the 267 articles identified, 16 were selected for the final analysis.

Results: The studies suggest that MC can improve mental health, sleep, appetite, and pain in cancer patients and decrease nausea, vomiting, and the use of other medications, such as opioids. Increased survival time and cognitive function improvements were also observed, with mild or moderate adverse effects. Both tetrahydrocannabinol and cannabidiol (full spectrum) were commonly used, with varied intervention durations.

Conclusion: Despite differences and methodological limitations, including only four randomized clinical trials, which precluded systematic review or meta-analysis, findings suggest that MC may improve QoL for cancer patients by alleviating physical and psychosocial symptoms associated with cancer treatment. In contrast, some mild or moderate adverse effects may be present. Moreover, the use of MC faces challenges such as the interaction with some chemotherapy treatment. More randomized controlled trials are needed to better understand the effects of MC among oncology patients.

Background: The minimally invasive repair of pectus excavatum (MIRPE), a surgical procedure done primarily in adolescence to correct pectus excavatum (PE), a congenital chest wall deformity, is associated with significant postoperative pain and opioid consumption. The use of an integrative medicine (IM) approach-combining complementary therapies with conventional treatments-can support postoperative pain management and potentially reduce opioid consumption in adolescent patients undergoing this procedure. This scoping review examines the published literature addressing the use of IM modalities in adolescent patients undergoing MIRPE.

Methods: A comprehensive search of MEDLINE, EMBASE, Web of Science Core Collection, and Google Scholar was conducted from inception through January 2024. Studies were included if they addressed the inclusion of at least one IM modality during the MIRPE perioperative to support pain management. These modalities could be delivered at any time during that period and used alongside any conventional analgesic methods.

Results: Eleven studies met the inclusion criteria. Eight of these (72.7%) implemented an integrative modality in this population. Of these eight, the most common integrative modalities were mindfulness/purposeful relaxation (n = 5), self-hypnosis (n = 3), cognitive-behavioral therapy (CBT) (n = 2), music/music therapy (n = 2), aromatherapy (n = 1), and massage (n = 1). Only six studies described the use of an integrative modality as an experimental condition. Still, self-hypnosis (n = 3), CBT (n = 2), and virtual reality-guided relaxation (n = 1) all augment postoperative pain management. While these studies have low levels of evidence and/or small sample sizes, they still demonstrated reduced pain scores (n = 4) and opioid consumption (n = 2) without appreciable adverse effects.

Conclusion: There is a paucity of literature examining the use of integrative modalities in adolescent patients undergoing MIRPE. The included studies demonstrate preliminary evidence of the positive outcomes associated with IM modalities overall and a low-risk profile. However, the small number of studies, observational and retrospective designs, limited sample sizes, and large heterogeneity across the studies demonstrate limited, low-level evidence, highlighting a need for further rigorous research to determine the efficacy of these modalities. Further investigation, especially in specific promising modalities such as hypnosis and guided relaxation, is warranted. Incorporating IM modalities into perioperative care for this population should be further explored.

Background: Pain during dental injections can negatively impact children's perception of dental visits. Various methods have been explored to reduce this pain.

Aim: This study aimed to assess the effect of sweet aromatherapy on injection pain associated with infiltration anesthesia for primary maxillary molars in 7-9-year-old children.

Design: In this randomized, double blind controlled clinical trial, 48 children (7-9 years old) requiring infiltration anesthesia for maxillary molars were randomly allocated to three groups (n = 16 each) (I) control group receiving anesthetic injection in an unscented room; (II) anesthetic injection in a room saturated with 2% sweet vanilla scent, and (III) anesthetic injection simultaneous with exposure to 2% sweet vanilla scent for 30 sec. Subjective pain was measured using the Wong-Baker Faces Pain Rating Scale, while objective pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) behavioral scale. Heart rate (HR) and blood oxygen saturation (SpO₂) were also recorded as physiological indicators. Data were analyzed using SPSS version 25.

Results: The FLACC scores and HR in the intervention groups was significantly lower than that in the control group (P = 0.05). Regarding SpO₂, only the difference between the control and saturated room groups was statistically significant (P < 0.05). There was no statistically significant difference in Wang-Baker score between groups (P > 0.05).

Conclusion: Two percent sweet vanilla scent can be a successful distraction method to reduce injection pain during infiltration anesthesia for maxillary molars in children aged 7-9 years. Further research in different age groups with a larger sample size seems necessary to strengthen the evidence.

Background: A reliable manual examination has not been validated as a diagnostic tool for nociplastic visceral pain.

Aims: To establish the interrater reliability of a manual examination protocol for functional pancreatic visceral dysfunction and the clinical criteria for a manual palpatory diagnosis based on the clinical features of the nociplastic visceral pain.

Methods: This double-blind cross-sectional study involved 60 participants assessed by three raters using a manual protocol for diagnosing functional pancreatic visceral dysfunction. Five palpation-based criteria were evaluated: (1) local pain, (2) referred pain, (3) neurovegetative symptoms, (4) hyperalgesia or allodynia, and (5) tissue resistance/density. Interrater agreement was measured using percentage agreement and Fleiss' kappa. The reliability of the Verbal Numerical Rating Scale (vNRS) was assessed using the intraclass correlation coefficient (ICC). Repeated measures analysis of variance and Cochran's Q test (with Bonferroni correction) were used to analyze vNRS scores and categorical outcomes, respectively. Significance was set at p < 0.05.

Results: Criteria 1, 3, and 4 showed particularly high levels of agreement, with overall agreement percentages of 93.3%, 95.6%, and 95.6%, respectively. The corresponding Fleiss' kappa values were 0.863, 0.880, and 0.908, indicating almost perfect agreement. In contrast, Criteria 2 and 5 demonstrated substantial, but comparatively lower, agreement, with overall percentages of 86.7% and 87.8% and Fleiss' kappa values of 0.679 and 0.755. The vNRS demonstrated excellent reliability across all three pancreas regions, with ICC values well >0.90: head (ICC = 0.943, 95% confidence interval [CI] = 0.913-0.964), body (ICC = 0.950, 95% CI = 0.923-0.968), and tail (ICC = 0.963, 95% CI = 0.944-0.977).

Conclusions: Three blinded raters reached an almost perfect pair-wise interrater agreement on the presence or absence of functional visceral dysfunction in the topographic projection of the pancreas. This study provides preliminary evidence that a manual diagnostic protocol is a reliable and potentially useful diagnostic tool in diagnosing nociplastic pain in the topographic projection of the pancreas. Future research should prioritize evaluating the validity of the nociplastic visceral pain diagnosis.

Background: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19.

Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions.

Inclusion criteria: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs).

Results: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004).

Conclusions: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.