Journal of Integrative and Complementary Medicine最新文献

Purpose: To evaluate whether Matricaria chamomilla (Chamomile) supplementation enhances quality of life (QOL) specifically in vasomotor, psychological, physical, and sexual domains among postmenopausal women in Iran, where research on natural remedies for menopause management is limited.

Methods: In this triple-blind randomized controlled trial, 80 postmenopausal women aged 47-62 years were randomly assigned to receive either 400 mg Chamomile capsules daily (standardized to 1.2% apigenin) or placebo for 12 weeks. Randomization was performed using permuted blocks, and the study was triple-blinded (participants, researchers, and data analysts). QOL was assessed using the Menopause-Specific Quality of Life Questionnaire at baseline and 12 weeks. Data were analyzed using analysis of covariance with baseline score adjustments and an intention-to-treat approach for missing data.

Results: Chamomile significantly reduced vasomotor symptoms compared to placebo (mean difference = -0.82, 95% confidence interval: -1.25 to -0.39, p ≤ 0.001). No significant improvements were observed in psychological, physical, sexual, or overall QOL scores. Mild side effects (mouth sores, skin spots) caused the withdrawal of two participants from the Chamomile group.

Conclusions: Chamomile supplementation demonstrates efficacy in alleviating vasomotor symptoms in postmenopausal women, likely due to its phytoestrogenic properties, but has a limited impact on other QOL domains.

Objective: To investigate whether acupuncture enhances knee joint muscle endurance effectiveness and time-dependent effects after anterior cruciate ligament (ACL) injuries.

Methods: This randomized, single-blinded crossover trial included 20 males with ACL injuries. Participants were randomly divided into real acupuncture (RA) group and sham acupuncture (SA) group. RA was stimulated at ST32, ST34, ST36, SP10, and BL57; the SA received acupuncture 1-3 cm near these specific acupoints for 15 min. Both groups underwent RA and SA with a 1-week washout in between. Primary outcomes included kinetic and blood biochemical parameters. Kinetic variables (maximum torque, peak power, maximum average torque, average work, average power, total work, and joint stiffness) were assessed at six time points: pre-intervention and 3, 13, 23, 33, and 43 min postintervention. Blood biochemical markers (glucose, creatine, lactate, ammonia, carnitine, and glutathione) were measured at three time points: pre-exercise, postacupuncture, and postexercise.

Results: Significant group × time interaction on isokinetic parameters, joint stiffness, ammonia, lactate, and glutathione (all P < 0.05). Post hoc tests revealed significant increases in isokinetic parameters and stiffness at post1-post3/post4, and ammonia, lactate, and glutathione increased significantly postexercise (all P < 0.05). Compared with the SA, the isokinetic parameters, stiffness, ammonia, lactate, and glutathione were significantly different (all P < 0.05). No significantly difference between groups in glucose and creatine kinase (all P > 0.05), and both increased with time (all P < 0.05).

Conclusion: Acupuncture can immediately improve knee joint endurance in ACL injury patients, with time effects lasting 23-33 min after needle removal.

Background: This policy analysis examines the framework and strategic objectives of the World Health Organization (WHO) Global Traditional Medicine Strategy 2025-2034, with particular attention to its articulation of a people-centered health systems approach. The analysis explores how the strategy represents an evolution from earlier WHO strategies by embedding principles of holism, equity, cultural respect, and autonomy within its operational guidance for traditional, complementary, and integrative medicine (TCIM), while also interrogating the assumptions and implementation challenges associated with this shift.

Methods: A qualitative policy document analysis was conducted using thematic synthesis. The WHO Global Traditional Medicine Strategy 2025-2034 was analyzed as the primary source, with supplementary WHO documents used for contextualization. Text segments related to people-centered care were systematically coded and mapped against established domains of patient-centered practice and people-centered health systems, including autonomy, informed choice, cultural appropriateness, coordinated care, and equity. Themes were iteratively refined to assess how people-centered principles are operationalized within the strategy.

Results: The analysis finds that people-centeredness is structurally embedded across the strategy's vision, guiding principles, and strategic action areas. Key operational mechanisms include an emphasis on risk-based regulation and safety to support informed choice, integration of TCIM into primary health care to improve equitable access and coordination, and a broadened approach to evidence generation that incorporates patient-reported outcome measures alongside other methodological approaches. However, the analysis also identifies potential vulnerabilities related to variable regulatory capacity, evidence heterogeneity, resource constraints, and contextual differences across health systems.

Conclusion and policy implications: The WHO Global Traditional Medicine Strategy 2025-2034 provides a coherent framework for advancing people-centered integration of TCIM, but its effectiveness depends on careful, context-sensitive implementation. Member States must balance autonomy with safety, cultural respect with scientific rigor, and inclusivity with accountability. Actionable priorities include strengthening risk-based regulatory systems, investing in TCIM research and development infrastructure using pluralistic methodologies, and cultivating interprofessional and multi-stakeholder governance to translate people-centered principles into sustainable health system practice.

Introduction: Chronic pain is a prevalent condition in the United States, and multimodal treatment approaches are the hallmark of management. Yoga therapy is a targeted, systematic approach for treating patients with specific conditions, using focused breathing and relaxation techniques. The purpose of this observational study was to evaluate the impact of yoga therapy on periprocedural pain, anxiety, and satisfaction in patients with chronic pain undergoing interventional procedures.

Materials and methods: A total of 36 voluntary subjects participated in this prospective study. Nineteen had a yoga therapist guide them through periprocedural yoga therapy techniques, and 17 underwent the procedure without a yoga therapist. Periprocedural vital signs and pre- and postsurvey responses relating to patient-reported severity of pain, anxiety, and satisfaction were collected and compared between the two groups.

Results: The mean difference in Visual Facial Anxiety Scale anxiety rating of patients receiving yoga therapy was 1.12 (95% confidence interval [CI]: -2.11 to -0.12, p = 0.029) points lower than that of patients without therapy. The mean difference in Numeric Rating Scale-10 pain score of patients receiving yoga therapy was 1.93 (95% CI: -3.78 to -0.07, p = 0.042) points lower than that of patients without therapy, controlling for procedural sedation. There were no significant differences in vital signs or overall patient satisfaction (Patient Global Impression of Change-7) following the procedure.

Discussion: In patients with chronic pain undergoing interventional procedures, participation in yoga therapy may be associated with a significant reduction in periprocedural anxiety and pain. Further investigation through a randomized controlled trial is necessary to verify these preliminary findings.

Conclusion: Yoga therapy may be considered in a multimodal approach to perioperative pain and anxiety management.

Introduction: Chinese medicine (CM) conceptualizes "dampness" as a burden of specific symptoms and signs, yet its quantitative relationship with biomedically defined heart failure (HF) stages and prognosis remains unclear. The authors evaluated a CM-derived dampness score in relation to the updated HF stages and 12-month major adverse cardiovascular events (MACEs).

Methods: The authors prospectively enrolled adults hospitalized for cardiovascular care between 2023 and 2025. At baseline, clinicians assigned HF Stages A-D as per guidelines. Dampness manifestations were scored with a structured CM scale, and patients were followed for 12 months for MACEs. They compared the dampness burden across stages and used logistic regression and restricted cubic spline models to examine its association with MACEs.

Results: Among 797 patients, the prevalence of dampness syndrome increased from 40.4% in Stage A to 88.1% in Stage D, and the mean dampness score increased from 6.2 ± 2.1 to 24.3 ± 5.6 (p < 0.001). During the 12-month follow-up period, 141 of 738 participants (19.1%) experienced MACEs. Each 1-point increase in the dampness score was independently associated with higher odds of MACEs (adjusted odds ratio = 1.17, 95% confidence interval: 1.13-1.20; p < 0.001), and the dose-response curve was approximately linear.

Conclusions: In this cohort, CM-defined dampness manifestations increased across HF stages and were linearly associated with the 12-month risk of MACEs. A simple quantitative dampness score may complement conventional risk assessment and provide a pragmatic way to integrate CM evaluation into routine HF management.

Background: Compelling research has indicated that habitual glucosamine use was related to lower risks of cardiovascular disease (CVD) events. However, whether the inverse association is still valid in individuals with diabetes, who take on greater risk of CVD, remains unknown. Therefore, we aimed to examine the association between habitual glucosamine use and CVD in patients with prediabetes and diabetes.

Methods: This cohort study included 54,096 participants with glucosamine use information identified from the UK Biobank. Cox regression was used to assess the association of habitual glucosamine use with total CVD events and CVD subtypes in the population with diabetes and prediabetes. We also evaluated the combined impact of C-reactive protein (CRP) level and genetic susceptibility on heart failure, ischemic heart disease (IHD), and stroke.

Results: During a median follow-up of 10.56 years, 30,716 cases of overall CVD events were ascertained. We found significant inverse associations between glucosamine use and risk of CVD events among participants with diabetes and prediabetes (overall CVD events: hazard ratio, 0.94 [95%confidence interval: 0.91-0.96]; heart failure: 0.89 [0.81-0.99]; IHD: 0.89 [0.84-0.95], and stroke: 0.86 [0.77-0.97]). The effect of glucosamine on CVD was more pronounced in individuals with low CRP levels (0.85 [0.82-0.89]). Compared with individuals with high genetic risk and not-using glucosamine, glucosamine users with low genetic risk (heart failure: 0.64 [0.52-0.80]; IHD: 0.48 [0.42-0.55]) exhibited the lowest risks of corresponding CVD events.

Conclusion: Habitual glucosamine use was associated with lower risks of CVD events in the population with diabetes and prediabetes. The association was more pronounced in individuals with low CRP level and low CVD polygenic risk score level, which helps us to identify the target population more suitable for glucosamine use.

Background: Use of complementary and integrative health (CIH) therapies has increased over the past two decades. Accumulating evidence supports the effectiveness of CIH therapies for a range of health outcomes and an association between CIH therapy use and reduced use of opioid therapy.

Objective: To describe differences in the use of evidence-based CIH therapies among individuals with chronic pain on long-term opioid therapy (LTOT) by sociodemographic and clinical characteristics.

Design: This was an observational study using a national retrospective cohort of patients developed from Veterans Affairs (VA) electronic health record data.

Sample: The sample comprised 281,903 patients receiving LTOT upon cohort entry between July 1, 2017, and December 31, 2021, with a health care encounter in one of 54 VA medical centers.

Main measures: CIH therapy use was defined as chart-documented use of any of eight priority CIH therapies or chiropractic care in the year prior to cohort entry. LTOT was defined as having a prescribed opioid analgesic for ≥90 consecutive days, allowing ≤30 days between fills. Sociodemographic and clinical characteristic variables were assessed as covariates of CIH therapy use.

Key results: Among the full cohort, the CIH therapy use rate was 9.5%. Use increased with each cohort entry year relative to 2017. In a multivariable model, variables associated with greater odds of CIH therapy use included being female, having a musculoskeletal pain condition, obesity, opioid use disorder, anxiety, depression, post-traumatic stress disorder, and receiving services in a flagship site. Lower odds of use were associated with being older, unmarried, prescribed higher opioid doses, smoking, and rural residence.

Conclusions: CIH therapy use has increased over time, consistent with national trends; however, differential patterns of exposure suggest the need to explore pathways to use. These may elucidate opportunities to broaden access to these evidence-based therapies for patients with chronic pain.

Objects: The purpose of this study is to investigate whether (1) acupuncture is effective in improving insulin resistance (IR) in patients with diabetes mellitus (DM) and (2) the effect of acupuncture varies depending on the type and dosage of acupuncture.

Methods: PubMed, Embase, Web of Science, Cochrane Library, OpenGrey, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry were searched from their inception up to April 26, 2025. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. The Grading of Recommendations Assessment, Development and Evaluation approach was used to evaluate the credibility of findings from each outcome. Systematic review and pairwise and exploratory network meta-analysis (NMA) of randomized controlled trials (RCTs) were conducted to investigate the effectiveness and safety of acupuncture on IR in patients with DM.

Results: We included 16 RCTs from 2328 citations with 1087 participants. When compared with usual care, acupuncture had a significant effect on the homeostatic model assessment of IR (HOMA-IR; standardized mean difference [SMD] = -1.13, 95% confidence interval [CI]: -1.61 to -0.64), fasting blood sugar (FBS; SMD = -0.90, 95% CI: -1.45 to -0.35), and glycated hemoglobin (HbA1c; SMD = -0.66, 95% CI: -1.11 to -0.20) but not on 2-h blood glucose (2hBG; SMD = -1.32, 95% CI -2.83 to 0.19). When compared with sham acupuncture, acupuncture had a significant effect on FBS (SMD = -0.71, 95% CI: -1.18 to -0.25) but not on HbA1c (SMD = -0.14, 95% CI: -0.48 to 0.19). Subgroup analysis revealed that high-dose acupuncture had a more beneficial effect on HOMA-IR and 2hBG. According to the NMA, electroacupuncture (EA) might be the most promising acupuncture type for improving IR. However, we failed to analyze safety outcomes due to the inadequate data across the included studies.

Conclusion: The findings suggested that acupuncture could be an effective therapy to improve IR in patients with diabetes. EA and high-dose acupuncture are two potential contributing factors.