Journal of Integrative and Complementary Medicine最新文献

Aim: This study is based on a registered trial (TCTR20241119007), in which the primary outcome was visual fatigue. The current study aims to evaluate the effects of specialized Thai yoga facial massage (STYFM) on heart rate variability (HRV) as a physiological marker associated with autonomic regulation.

Methods: This two-arm randomized controlled trial was conducted at Khon Kaen University, Thailand, from January to February 2025. Thirty-two individuals with computer vision syndrome were randomly assigned to receive either a 4-week program of self-administered STYFM or eyes-closed seated rest under identical conditions without tactile or auditory stimulation. Each session lasted 10 to 15 min and took place 10 times per week. Physiological parameters, including HRV, heart rate (HR), and peripheral oxygen saturation (SpO₂), were assessed at the baseline, mid-intervention, and post-intervention. Data were analyzed using linear mixed models with Bonferroni correction.

Results: The STYFM intervention significantly improved autonomic regulation compared to the control group. Participants in the STYFM group showed notable increases in HRV parameters, including the standard deviation of normal-to-normal intervals (p < 0.001), root mean square of successive differences (p < 0.001), the percentage of successive RR intervals differing by more than 50 ms (p < 0.001), total power (p = 0.004), low-frequency power (LF, p = 0.049), and high-frequency power (HF, p < 0.001). The LF/HF ratio decreased but was not statistically significant (p = 0.194). Additionally, the STYFM group demonstrated significantly higher peripheral oxygen saturation (p < 0.001) and reduced HR (p < 0.001), with no adverse events reported.

Conclusion: This analysis suggests that STYFM significantly improved HRV, increased SpO2, and reduced HR, indicating enhanced parasympathetic modulation and improved autonomic regulation. Since this study represents a preliminary study of a larger clinical trial, it is important to note that the outcome data for the registered primary endpoint (visual fatigue score) will be reported in a separate publication.

Objectives: This study aimed to evaluate the effects of Reiki on pain, anxiety, and hemodynamic parameters in patients receiving invasive mechanical ventilation (IMV) in an adult intensive care unit.

Methods: A single-blind, randomized, sham-controlled experimental design was used. Sixty patients undergoing IMV were randomly assigned to either the Reiki group (n = 30) or the sham Reiki group (n = 30). The Reiki group received a 30-min Reiki session, while the sham group received a 30-min simulated session by a noncertified individual with no energy transmission intent. The primary outcome was the change in pain score measured by the Critical Care Pain Observation Tool (CPOT). Secondary outcomes included anxiety level, systolic and diastolic blood pressure, heart rate, and respiratory rate. Data collection tools included the Patient Identification Form, Face Anxiety Scale, CPOT, and a Hemodynamic Parameters Form.

Results: Multivariate analysis revealed significant main effects of time (p < .001) and a significant time × group interaction (p = .001) on CPOT and FAS scores. Reiki significantly reduced pain (p = .002) and anxiety levels (p = .006) compared to the sham Reiki group. In terms of hemodynamic parameters, Reiki was more effective in reducing diastolic blood pressure (p = 0.019) and heart rate (p = 0.001). Systolic blood pressure showed a marginal effect (p = 0.052), while respiratory rate demonstrated a significant group effect (p = 0.047) without a time × group interaction.

Conclusions: Reiki demonstrated beneficial effects on pain, anxiety, and certain hemodynamic parameters, particularly diastolic blood pressure and heart rate, with more limited effects on systolic blood pressure and respiratory rate (Trial registration ID: NCT06526949).

Introduction: Prelabor rupture of membranes (PROM) at term increases the risk of maternal and neonatal complications. While expectant management aims to allow spontaneous labor, it can lead to infection, whereas active management may result in unnecessary interventions. Acupuncture (ACU) has been suggested as a nonpharmacological method to promote labor onset and reduce the need for induction. This randomized controlled trial aimed to assess the efficacy of ACU in women with PROM at ≥37 weeks' gestation.

Materials and methods: Eligible women with singleton pregnancies, negative Group B Streptococcus swab, and reassuring maternal-fetal conditions were randomly assigned to receive either ACU or observation after a 6-h latency period. A total of 138 women were analyzed (69 per group). ACU treatment involved point selection based on Traditional Chinese Medicine to stimulate uterine activity and reduce anxiety. The primary outcome was the rate of labor induction; secondary outcomes included labor duration, time from PROM to labor/delivery, and delivery outcomes.

Results: The induction rate did not significantly differ between groups (49.2% in ACU versus 60.8% in controls; p = 0.172). However, ACU significantly reduced the time from PROM to labor onset and delivery and the time from induction to delivery. These differences, however, lost significance after adjustment for confounding variables. In a subgroup analysis of women undergoing labor induction, ACU significantly reduced the induction-to-delivery interval (p = 0.01). No differences were found in cesarean section rates, operative deliveries, epidural requests, or neonatal outcomes. No adverse events related to ACU were reported.

Conclusions: This study suggests that ACU may not reduce the need for labor induction in PROM at term but could shorten labor duration in women undergoing induction. Further larger, powered trials are needed to confirm these findings and better define the role of ACU in obstetric care.

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.