Journal of Integrative and Complementary Medicine最新文献

Background: Chronic liver diseases (CLDs) are major contributors to hepatic disorder-related morbidity and mortality worldwide. LIV-52, a herbo-mineral product, has demonstrated anti-inflammatory and immunomodulatory properties. Objective: Several randomized controlled trials (RCTs) have been conducted to verify its hepatoprotective effects across diverse patient groups with CLDs. This study aims to perform a meta-analysis to evaluate the therapeutic efficacy of LIV-52 in liver diseases. Data Sources: PubMed, the Cochrane Library, EMBASE, and Web of Science were searched to identify eligible RCTs published through March 10, 2025, where the efficacy of LIV-52 was compared with usual treatments for liver diseases. Meta-analysis was performed using RevMan and GRADEPro software. Eligibility Criteria: RCTs comparing LIV-52 with or without standard care in patients with CLDs. Data Collection and Analysis: Data were extracted independently by two reviewers. Meta-analysis was performed using a random-effects model. Results: From the 10 RCTs involving 758 patients, the hepatoprotective effects of LIV-52 treatment were examined. Benefits were noted in the areas of appetite loss (odds ratio = 0.25, confidence interval [CI] = 0.06 to 1.00, p-value = 0.05), renormalization of the liver enzyme serum-glutamic-pyruvic transaminase (SGPT; mean difference [MD] = -16.37, CI = -30.87 to -1.88, p-value <0.03), and improvement in fat metabolism in patients with liver cirrhosis (zinc sulfate [ZnS] turbidity [MD = 6.76, CI = 2.4 to 11.12, p-value <0.002] and fecal fat secretion [MD = -1.66, CI = -2.53 to -0.75, p-value <0.0001]). However, no significant effects of LIV-52 were observed for liver enzymes such as serum-glutamic-oxaloacetic transaminase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and the hematological parameters. The overall quality of evidence (QoE) as assessed using GRADEPro ranged from very low to moderate, with the majority of comparisons supported by low or very low due to small sample sizes and high bias risks, while the findings for some outcomes, hemoglobin and prothrombin time outcomes, supported moderate-quality evidence. Adverse events (AEs) were assessed in three RCTs; no intervention-related AEs were reported. Conclusion: The findings of this meta-analysis suggest that LIV-52 offers certain hepatoprotective benefits, particularly in improving appetite, normalizing SGPT levels, and enhancing fat metabolism in patients with liver diseases. The broader efficacy of LIV-52 is limited, and the low QoE warrants cautious interpretation. Further high-quality, large-scale studies are needed to enhance the certainty of evidence and confirm the LIV-52 efficacy and safety across all outcomes.

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.

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.

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.

Aim: This study was conducted to determine the effect of footbath on premenstrual syndrome (PMS), sleep quality, and quality of life in university students with PMS. Materials and Methods: This randomized controlled trial was conducted during the 2021-2022 academic year with students from the Faculty of Education at a university in the Black Sea Region of Turkey. Data were collected between November 2021 and June 2022. Following screening with the Premenstrual Syndrome Scale (PMSS), 78 students were randomly assigned to the intervention (n = 39) and control (n = 39) groups using a computer-generated sequence (1:1 ratio). Before starting the intervention, the Pittsburgh Sleep Quality Index (PSQI) and the SF-36 Quality of Life Scale (SF-36) were applied to both groups. Students in the intervention group received footbaths with water at 38°C-42°C every night for 7-10 days during the premenstrual phase of each cycle for three menstrual cycles. The control group received no intervention. The PMSS, PSQI, and SF-36 were readministered at the end of each cycle. The primary outcome was the change in PMSS scores; secondary outcomes included PSQI and SF-36 subscales. Data were analyzed using descriptive statistics, the Shapiro-Wilk test, and a two-way mixed ANOVA. Results: Post-test mean scores of the PMSS and its subscales (depressive mood, anxiety, fatigue, irritability, depressive thoughts, pain, and sleep changes) showed statistically significant differences between the intervention and control groups (p < 0.05). While a significant within-group improvement in PSQI scores was observed in the intervention group, no statistically significant between-group difference in sleep quality was found (p > 0.05). For the SF-36 subscales, bodily pain, vitality (energy), role emotional, and mental health scores significantly improved in the intervention group compared with the control group (p < 0.05). Conclusion: Footbath was found to reduce PMS symptoms and improve quality of life in students with PMS. However, it did not lead to a statistically significant improvement in sleep quality when compared with the control group.