Journal of Integrative and Complementary Medicine最新文献

Introduction: Musculoskeletal pain (MSP) is prevalent and a major cause of disability, highlighting the need for nonpharmacologic treatments. Low-level laser therapy auriculotherapy (LLLT-AT) is emerging as a promising noninvasive approach for MSP management. Objective: This systematic review aimed to evaluate the effects of LLLT-AT on MSP patients. Method: A comprehensive electronic search of PubMed, Web of Science, Scopus, Cochrane Library, CINAHL, ScienceDirect, PEDro, and Google Scholar (updated on May 3, 2025) identified randomized clinical trials (RCTs) comparing LLLT-AT with sham, no intervention, or other therapies. Pain intensity was the primary outcome, and disability and pain pressure threshold were secondary. Methodological quality was assessed using the PEDro scale. The risk of bias among the included RCTs was assessed using the Cochrane Risk of Bias 2.0 (RoB 2) tool, and the meta-analysis was performed using the mean difference (MD) or standardized mean difference (SMD), as appropriate. The Grading of Recommendation, Assessment, Development, and Evaluation framework guided evidence certainty. Results: Five RCTs were included, with a mean PEDro score of 7 (standard deviation [SD] 0.7). According to Domain 6 of the RoB 2 tool, 80% of trials demonstrated a low overall risk of bias, with evaluators blinding being the primary concern. LLLT-AT significantly reduced pain intensity post-treatment compared with placebo (SMD = 1.31; 95% confidence interval [CI]: 0.40-2.30; p < 0.01) and no treatment (SMD = 1.12; 95% CI: 0.00-2.20; p < 0.01), reflecting a large effect size. An increase in the pressure pain threshold was also observed (MD = 0.64; 95% CI: 0.00-1.30; p < 0.01), although this result was limited by small sample sizes. However, the certainty of the evidence was judged as very low-deemed critical for pain intensity outcomes and not important for pressure pain threshold. No adverse events were reported. Conclusion: LLLT-AT shows potential for effectively managing MSP, reducing pain intensity, and improving pressure pain threshold. However, further research is needed to strengthen the evidence base due to the limited number of studies and to explore its applicability to other conditions. Dosage recommendations were provided to inform future research and clinical practice.

Introduction: Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder characterized by intrusive and repetitive behaviors impairing daily life. Although cognitive-behavioral therapy and medications are primary treatments, recent studies highlight yoga potential benefits. Purpose: This study aimed to summarize the effectiveness of yoga in managing OCD symptoms and improving overall mental well-being. Methods: A comprehensive literature review was conducted across PubMed, Embase, and Scopus databases, identifying a total of 252 records. After removing 124 duplicates, 128 articles were screened based on title and abstract. Studies were excluded if they were reviews, meta-analyses, editorials, case reports (N = 26), and lacked yoga-based interventions (N = 11), or focused on conditions other than OCD (N = 45). Forty-six full-text articles were assessed for eligibility, with 39 exclusions for being reviews, editorial, case reports (N = 21), addressing conditions other than OCD (N = 4), or being out of topic (N = 14). Seven studies met the inclusion criteria and were analyzed in this review. Qualitative rating of included studies was performed by the Qualitative Assessment Tool for quantitative studies. Results: The included studies showed that yoga interventions led to significant reductions in OCD symptom severity, as measured by standardized assessment tools such as the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Various forms of yoga, including kundalini and rajyoga, were associated with improved mental health outcomes, reduced anxiety levels, and enhanced overall well-being. However, the generalizability of these findings is limited due to heterogeneity in study design, small sample sizes, and variations in intervention protocols. Conclusions: The findings suggest that yoga-based interventions may be effective as adjunctive therapies alongside conventional treatments for OCD. However, well-designed randomized controlled trials with standardized methodologies are needed to establish definitive conclusions.

Background: Systematic studies and follow-up evaluation of the effects and duration of Baduanjin exercises are still lacking. This study used a meta-analysis to systematically evaluate the effectiveness and safety of long-term cardiac rehabilitation using Baduanjin exercise in patients with chronic heart failure (CHF). Methods: Eight databases were searched up to June 2, 2025. Two reviewers independently screened the included titles, then extracted trial and patient characteristics and outcome data and assessed the risk of bias. The meta-analysis was performed using Stata software 17.0, with cardiac function, exercise capacity, and quality of life pooled as either short-term (12 weeks) or long-term follow-up. Changes in left ventricular ejection fraction, depression, readmission rate, and efficiency rate were also analyzed. Results: A total of 21 randomized controlled trials involving 1594 patients (805 in the intervention group and 789 in the control group) were included in the meta-analysis. The results showed that long-term Baduanjin exercise was associated with indices of cardiac function and favorable improvements in overall quality of life (mean difference [MD] = -1.33; 95% confidence interval [CI]: -1.65 to -1.00; p < 0.00001), left ventricular ejection fraction (MD = 0.46; 95% CI: 0.21-0.71; p < 0.00001), exercise capacity (MD = 1.10; 95% CI: 0.72-1.48; p < 0.00001), depression (MD = -0.61; 95% CI: -0.94 to -0.29; p = 0.00;), and efficiency rate (OR = 3.19; 95% CI: 2.04-4.98; p < 0.00001). The improvements in cardiac function, quality of life, and exercise capacity were more pronounced with long-term Baduanjin exercise than with short-term exercise. These changes were not statistically significant (risk ratio = 0.31; 95% CI: 0.09-1.07; p = 0.06), although there was a trend toward an improvement. Analysis of the safety data indicated no serious adverse events. Conclusions: Long-term Baduanjin exercise may improve quality of life, exercise capacity, and psychological well-being in patients with CHF. This finding indicates it may have potential as an effective component of cardiac rehabilitation, although further rigorous studies are needed to confirm these benefits.

Objective: The primary goal of treatment for endometriosis (EMS), where pelvic pain is the most significant symptom, is the symptom alleviation. Medical treatment is typically employed until menopause or until pregnancy is desired. The primary outcome of this randomized controlled trial was the reduction in pelvic pain intensity as measured by the visual analog scale (VAS). Secondary outcomes included quality-of-life (QoL) parameters assessed using the short form 36 (SF-36) subscales. Therefore, this study aimed to evaluate the effectiveness of emotional freedom techniques (EFTs) in women experiencing pelvic pain due to EMS. Method: The research was conducted using a parallel-group, randomized controlled design. The EFT group received two EFT sessions (45-60 min each) once a month together with affirmation practices lasting 10-15 min at least twice a week. Control group participants performed breathing exercises parallel to the intervention group. Data were collected from 64 women (intervention: 32 and control: 32) presenting with pelvic pain complaints at the Gynecology Clinic of Trakya University between May 24, 2024 and October 27, 2024. Assessments were performed using the VAS and the SF-36-short form. Mixed-model analysis of variance was utilized to analyze the effects of time, group, and the time × group interaction. Statistical significance was set at p ≤ 0.05. Results: Compared with the control group, the EFT group showed a significant reduction in mean VAS pain scores (baseline: 7.34 ± 0.90; 1st month: 6.46 ± 0.67; 2nd month: 4.68 ± 0.53) (interaction η² = 0.323, p < 0.001). Improvements were also observed in SF-36 subscales, including physical functioning, emotional role functioning, vitality, mental health, social functioning, and pain (all p < 0.05), suggesting that EFT may reduce pelvic pain and improve the QoL. Conclusion: EFT was associated with reductions in pelvic pain intensity (the primary outcome) and improvements in multiple dimensions of the QoL among women with EMS-related pelvic pain. These findings suggest that EFT may be a beneficial complementary intervention for managing EMS symptoms.

Background and Aim: Vulvovaginal candidiasis (VVC), predominantly caused by Candida albicans, is a common fungal infection affecting women worldwide. This randomized, blinded clinical trial aimed to evaluate the therapeutic efficacy of Hypericum perforatum (St. John's Wort) vaginal gel in comparison with 1% clotrimazole cream for the treatment of VVC. Method: In this parallel-group, double-blind, randomized clinical trial, 80 women with microbiologically confirmed C. albicans vaginitis were randomly assigned to receive either H. perforatum vaginal gel or 1% clotrimazole cream, administered intravaginally once nightly for seven consecutive nights. Randomization was performed using a block method with concealed allocation. Primary outcomes included changes in clinical symptoms-itching, discharge, burning, and inflammation-from baseline to the end of treatment, assessed both clinically and via patient self-report. All analyses were conducted on an intention-to-treat basis. Results: Both treatment groups showed significant clinical improvement. The clotrimazole group had a higher rate of itching resolution (73.7% vs. 46.2%, p = 0.04), while the St. John's Wort gel group showed greater improvement in vaginal discharge (38.5% vs. 18.4% reported no discharge, p = 0.03). No adverse events were reported in either group. Conclusion: While both treatments improved symptoms, St. John's Wort gel was not superior to clotrimazole in this superiority trial. Further research is needed to explore its potential as an alternative or adjunctive therapy, particularly in specific symptom domains. Moreover, larger non-inferiority trials are required to assess comparative efficacy.

Objective: This study aimed to evaluate the synergistic effects of Gegen-Heisu decoction (GHD) combined with estrogen-progestin therapy on thin endometrium (TE)-related infertility. Methods: A single-center, prospective randomized controlled study was conducted from June 2023 to June 2024, enrolling 250 women with TE. Participants were randomly assigned to either the control group (estradiol and dydrogesterone) or the GHD group (GHD plus estradiol and dydrogesterone). The primary outcomes were endometrial thickness (EMT) and endometrial type on the ovulation day. Secondary outcomes included blood flow parameters, traditional Chinese medicine (TCM) syndrome scores, serum leukemia inhibitory factor (LIF), and vascular endothelial growth factor levels. Results: The GHD group demonstrated significant improvements in EMT (p < 0.001) and endometrial type (p = 0.005) compared with the control group. In addition, the GHD group exhibited a lower pulsation index and resistance index, as well as a higher peak systolic velocity of the uterine spiral arteries (p < 0.05). Patients in the GHD group also had lower TCM syndrome scores than those in the control group (p < 0.001) and higher serum LIF levels (p = 0.003). No hepatic or renal adverse effects were observed in either group. One participant in the GHD group experienced mild skin pruritus, and one participant in the control group reported gastrointestinal discomfort. Conclusion: The combination of GHD and estrogen-progestin therapy effectively enhances endometrial receptivity in women with TE. GHD modulates key cytokines, offering a promising adjunct therapy for TE-related infertility.

Background: Anxiety, depression, and sleep difficulties are mental health conditions (MHCs) that occur in up to 40% of young adults. Lifestyle practices, such as physical activity and quality diet, have been associated with better mental well-being; however, the use of lifestyle practices and the associations with MHCs among young adults are underexplored. Understanding these aspects may guide strategies to reduce the risk of MHCs via lifestyle choices. Methods: Data from the U.S. National Health Interview Survey, restricted to 3992 adults aged 18-30 years, were analyzed. Anxiety, depression, and sleep difficulties were assessed. Sixteen queried lifestyle practices were consolidated into the following: mind-body, body-based, physical activity, diet, substance use, and other. Prevalence estimates for MHCs and lifestyle practices were calculated. Logistic regression was used to assess the characteristics of young adults with each MHC, and the associations between lifestyle practices with each MHC. Results: Common characteristics of participants with anxiety, depression, or sleep difficulties were less likely to be male and more likely to be obese, using medications and health services, and reporting multiple chronic conditions. Across three groups of MHCs, mind-body practices were more frequently used than among their respective control populations. Across the MHC group, mind-body practices were significantly associated (adjusted odds ratio [aOR]_A= 1.53; aOR_D= 1.78; aOR_S= 1.53). Unhealthy diet was positively associated with anxiety and sleep difficulties (aOR_A= 1.48, aOR_S= 1.34), and substance use was positively associated with anxiety (aOR_A= 1.81). Conclusion: Young adults with MHCs may face certain socioeconomic and health-related disadvantages. Strategies targeting these disadvantaged populations to reduce unhealthy diet consumption and substance use may improve MHCs.

Introduction: Mild cognitive impairment (MCI) signifies a transitional phase between normal aging and dementia. As the disease progresses, MCI patients face considerable challenges due to the deterioration in cognitive function, activities of daily living (ADL), and neuropsychiatric symptoms. This study aims to evaluate the evidence regarding the application of acupoint therapy in individuals with MCI based on randomized controlled trials (RCTs). Methods: Six databases were searched to September 25, 2025, for RCTs comparing acupoint therapy (alone or combined with nonpharmacological treatments) with health education, blank or waiting groups, sham interventions, and standard treatments (nonpharmacological treatments or oral medications). Outcomes included Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Data on ADL scale, relevant biomarkers, and safety data were extracted where available. After the process of literature review and data collection, risk of bias was assessed with the Cochrane Risk of Bias 2.0. Meta-analyses were performed employing the Review Manager (version 5.4.1). Results: Twenty-four trials comprising 2005 patients were analyzed. Acupoint therapy improved the overall cognitive function of MCI patients (MoCA: mean difference [MD] = 1.47, 95% confidence interval [CI]: [0.95, 1.99], p < 0.00001; MMSE: MD = 1.44, 95% CI: [1.03, 1.86], p < 0.00001). MoCA and MMSE scores after acupoint therapy were significantly higher than those of health education control (MoCA: MD = 2.63, 95% CI: [1.19, 4.07], p = 0.0003; MMSE: MD = 2.83, 95% CI: [2.14, 3.51], p < 0.00001), sham control (MoCA: MD = 0.94, 95% CI: [0.18, 1.69], p = 0.01; MMSE: MD = 1.29, 95% CI: [0.51, 2.08], p = 0.001), standard nonpharmacological control (MoCA: MD = 1.42, 95% CI: [0.81, 2.03], p < 0.00001; MMSE: MD = 1.09, 95% CI: [0.79, 1.40], p < 0.00001), and oral-medication control (MoCA: MD = 0.52, 95% CI: [0.06, 0.98], p = 0.03; MMSE: MD = 0.91, 95% CI: [0.22, 1.61], p = 0.01), but no difference versus blank control (MoCA: MD = -1.10, 95% CI: [-4.58, 2.38], p = 0.54; MMSE: MD = 1.80, 95% CI: [-0.92, 4.52], p = 0.20). Auricular acupressure improved ADL scores. Biomarker changes remained nonsignificant. Only nine studies reported safety events with heterogeneous definitions, leaving the risk-benefit ratio unclear. Conclusion: Acupoint therapy is beneficial for cognitive function in MCI patients. Additional high-quality research is needed to provide a reliable basis for the management of MCI through acupoint therapy.