Pub Date : 2025-09-01Epub Date: 2025-06-25DOI: 10.1016/j.joim.2025.06.007
Xiao-yan Zheng , Zi-yi Jiang , Yi-ting Li , Chao-liang Li , Hao Zhu , Zheng Yu , Si-yi Yu , Li-li Yang , Song-yuan Tang , Xing-yu Lü , Fan-rong Liang , Jie Yang
Objective
To explore the association between acupuncture during controlled ovarian hyperstimulation (COH) and the live birth rate (LBR) using different propensity score methods.
Methods
In this retrospective cohort study, eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups. The primary outcome was LBR, as determined by propensity score matching (PSM). LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer. The propensity score model encompassed 16 confounding variables. To validate the results, sensitivity analyses were conducted using three additional propensity score methods: propensity score adjustment, inverse probability weighting (IPW), and IPW with a “doubly robust” estimator.
Results
The primary cohort encompassed 9751 patients (1830 [18.76%] in the acupuncture group and 7921 [81.23%] in the non-acupuncture group). Following 1:1 PSM, a higher LBR was found in the acupuncture cohort (41.4% [755/1824] vs 36.4% [664/1824], with an odds ratio of 1.23 [95% confidence interval, 1.08–1.41]). Three additional propensity score methods produced essentially similar results. The risk of serious adverse events did not significantly differ between the two groups.
Conclusion
This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH, and that acupuncture is a safe and valuable treatment option.
Please cite this article as: Zheng XY, Jiang ZY, Li YT, Li CL, Zhu H, Yu Z, Yu SY, Yang LL, Tang SY, Lü XY, Liang FR, Yang J. Association between acupuncture and live birth rates after fresh embryo transfer: A cohort study based on different propensity score methods. J Integr Med. 2025; 23(5):528–536.
{"title":"Association between acupuncture and live birth rates after fresh embryo transfer: A cohort study based on different propensity score methods","authors":"Xiao-yan Zheng , Zi-yi Jiang , Yi-ting Li , Chao-liang Li , Hao Zhu , Zheng Yu , Si-yi Yu , Li-li Yang , Song-yuan Tang , Xing-yu Lü , Fan-rong Liang , Jie Yang","doi":"10.1016/j.joim.2025.06.007","DOIUrl":"10.1016/j.joim.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the association between acupuncture during controlled ovarian hyperstimulation (COH) and the live birth rate (LBR) using different propensity score methods.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups. The primary outcome was LBR, as determined by propensity score matching (PSM). LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer. The propensity score model encompassed 16 confounding variables. To validate the results, sensitivity analyses were conducted using three additional propensity score methods: propensity score adjustment, inverse probability weighting (IPW), and IPW with a “doubly robust” estimator.</div></div><div><h3>Results</h3><div>The primary cohort encompassed 9751 patients (1830 [18.76%] in the acupuncture group and 7921 [81.23%] in the non-acupuncture group). Following 1:1 PSM, a higher LBR was found in the acupuncture cohort (41.4% [755/1824] <em>vs</em> 36.4% [664/1824], with an odds ratio of 1.23 [95% confidence interval, 1.08–1.41]). Three additional propensity score methods produced essentially similar results. The risk of serious adverse events did not significantly differ between the two groups.</div></div><div><h3>Conclusion</h3><div>This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH, and that acupuncture is a safe and valuable treatment option.</div><div>Please cite this article as: Zheng XY, Jiang ZY, Li YT, Li CL, Zhu H, Yu Z, Yu SY, Yang LL, Tang SY, Lü XY, Liang FR, Yang J. Association between acupuncture and live birth rates after fresh embryo transfer: A cohort study based on different propensity score methods. <em>J Integr Med</em>. 2025; 23(5):528–536.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 528-536"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-07-17DOI: 10.1016/j.joim.2025.07.004
Donato Giuseppe Leo , Simon S. Keller , Riccardo Proietti
Hypnosis is a promising tool in the management of various conditions, such as anxiety and chronic pain. Preliminary studies have shown that hypnosis can directly affect the cardiovascular system, as it increases parasympathetic activation and reduces sympathetic activity. However, the literature related to the effects of hypnosis on cardiovascular health is scarce, mainly due to misconceptions about hypnosis among researchers and medical professionals. This opinion paper examines the role that hypnosis may play in cardiovascular health, highlighting the physiological mechanisms behind it. The evidence suggests that hypnosis has both direct (e.g., changes in the activity of the autonomic nervous system) and indirect (e.g., changes in healthy behaviours) effects on the cardiovascular system; however, further studies are needed to properly define its mechanisms of action and its applicability in improving cardiovascular health. Thus, this opinion paper advocates the adoption of the term “hypno-cardiac physiology” to identify a new research area that gathers experts from neuroscience and cardiovascular science with the joint aim of seeking further understanding of the effects of hypnosis on the cardiovascular system. The adoption of a dedicated term to identify the study of the cardiovascular response to hypnosis will encourage its implementation in cardiovascular health interventions, promoting awareness of its effects among the public and the healthcare community, and promoting the formation of dedicated multidisciplinary research groups and dedicated educational training for healthcare professional interested in its applications.
Please cite this article as: Leo DG, Keller SS, Proietti R. Hypno-cardiac physiology: Aiming for an organised study of the physiological effects of hypnosis on the cardiovascular system. J Integr Med. 2025; 23(5):457–461.
{"title":"Hypno-cardiac physiology: Aiming for an organised study of the physiological effects of hypnosis on the cardiovascular system","authors":"Donato Giuseppe Leo , Simon S. Keller , Riccardo Proietti","doi":"10.1016/j.joim.2025.07.004","DOIUrl":"10.1016/j.joim.2025.07.004","url":null,"abstract":"<div><div>Hypnosis is a promising tool in the management of various conditions, such as anxiety and chronic pain. Preliminary studies have shown that hypnosis can directly affect the cardiovascular system, as it increases parasympathetic activation and reduces sympathetic activity. However, the literature related to the effects of hypnosis on cardiovascular health is scarce, mainly due to misconceptions about hypnosis among researchers and medical professionals. This opinion paper examines the role that hypnosis may play in cardiovascular health, highlighting the physiological mechanisms behind it. The evidence suggests that hypnosis has both direct (e.g., changes in the activity of the autonomic nervous system) and indirect (e.g., changes in healthy behaviours) effects on the cardiovascular system; however, further studies are needed to properly define its mechanisms of action and its applicability in improving cardiovascular health. Thus, this opinion paper advocates the adoption of the term “hypno-cardiac physiology” to identify a new research area that gathers experts from neuroscience and cardiovascular science with the joint aim of seeking further understanding of the effects of hypnosis on the cardiovascular system. The adoption of a dedicated term to identify the study of the cardiovascular response to hypnosis will encourage its implementation in cardiovascular health interventions, promoting awareness of its effects among the public and the healthcare community, and promoting the formation of dedicated multidisciplinary research groups and dedicated educational training for healthcare professional interested in its applications.</div><div>Please cite this article as: Leo DG, Keller SS, Proietti R. Hypno-cardiac physiology: Aiming for an organised study of the physiological effects of hypnosis on the cardiovascular system. <em>J Integr Med</em>. 2025; 23(5):457–461.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 457-461"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-06-30DOI: 10.1016/j.joim.2025.06.008
Hong-jun Kuang , Hui-sheng Yang , Yi-xuan Feng , Han Tang , Qi Fan , Yu-qin Xu , Shuo Cui , Richard Musil , Hedi Luxenburger , Yi-xuan Zhang , Hong Zhao , Yu-qing Zhang
<div><h3>Background</h3><div>Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder (MDD), but its efficacy and safety have still not been comprehensively assessed. Recently published systematic reviews remain confusing and inconclusive.</div></div><div><h3>Objective</h3><div>This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.</div></div><div><h3>Search strategy</h3><div>Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Science and Technology Journal Database, PubMed, Embase, and Cochrane Library were searched from their inceptions to March 2025.</div></div><div><h3>Inclusion criteria</h3><div>Randomized controlled trials that compared acupuncture therapy with antidepressants, or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.</div></div><div><h3>Data extraction and analysis</h3><div>Five reviewers independently extracted data from original literature using a standardized form, and the data were verified by two reviewers to ensure accuracy. Statistical meta-analyses, publication bias analyses, and subgroup analyses were performed by using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of the evidence.</div></div><div><h3>Results</h3><div>A total of 60 eligible studies including 4675 participants were included. Low-certainty evidence showed that compared with antidepressants, acupuncture therapy (standardized mean difference [SMD] = –0.57; 95% confidence interval [CI] = [–0.87, –0.27]; <em>I<sup>2</sup></em> = 86%; <em>P</em> = 0.006) or acupuncture therapy plus antidepressants (SMD = –1.00; 95% CI = [–1.18, –0.81]; <em>I<sup>2</sup></em> = 77%; <em>P</em> < 0.00001) may reduce the severity of depression at the end of treatment. Low-certainty evidence indicated that compared with acupuncture therapy alone, acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment (SMD = –0.38; 95% CI = [–0.61, –0.14]; <em>I<sup>2</sup></em> = 18%; <em>P</em> = 0.002). Similar results were also found for acupuncture’s relief of insomnia. The reported adverse effects of acupuncture therapy were mild and transient. For most of the subgroup analyses, acupuncture type, scale type, and the course of treatment did not show a significant relative effect.</div></div><div><h3>Conclusion</h3><div>Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD. But the certainty of evidence was very low. More high-quality, well designed, large-scale studies with long-term follow-up are needed in the future.</div><div>Pleas
{"title":"Efficacy and safety of acupuncture therapies for adult patients with mild and moderate major depressive disorder: A systematic review and meta-analysis","authors":"Hong-jun Kuang , Hui-sheng Yang , Yi-xuan Feng , Han Tang , Qi Fan , Yu-qin Xu , Shuo Cui , Richard Musil , Hedi Luxenburger , Yi-xuan Zhang , Hong Zhao , Yu-qing Zhang","doi":"10.1016/j.joim.2025.06.008","DOIUrl":"10.1016/j.joim.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder (MDD), but its efficacy and safety have still not been comprehensively assessed. Recently published systematic reviews remain confusing and inconclusive.</div></div><div><h3>Objective</h3><div>This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD.</div></div><div><h3>Search strategy</h3><div>Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Science and Technology Journal Database, PubMed, Embase, and Cochrane Library were searched from their inceptions to March 2025.</div></div><div><h3>Inclusion criteria</h3><div>Randomized controlled trials that compared acupuncture therapy with antidepressants, or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included.</div></div><div><h3>Data extraction and analysis</h3><div>Five reviewers independently extracted data from original literature using a standardized form, and the data were verified by two reviewers to ensure accuracy. Statistical meta-analyses, publication bias analyses, and subgroup analyses were performed by using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of the evidence.</div></div><div><h3>Results</h3><div>A total of 60 eligible studies including 4675 participants were included. Low-certainty evidence showed that compared with antidepressants, acupuncture therapy (standardized mean difference [SMD] = –0.57; 95% confidence interval [CI] = [–0.87, –0.27]; <em>I<sup>2</sup></em> = 86%; <em>P</em> = 0.006) or acupuncture therapy plus antidepressants (SMD = –1.00; 95% CI = [–1.18, –0.81]; <em>I<sup>2</sup></em> = 77%; <em>P</em> < 0.00001) may reduce the severity of depression at the end of treatment. Low-certainty evidence indicated that compared with acupuncture therapy alone, acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment (SMD = –0.38; 95% CI = [–0.61, –0.14]; <em>I<sup>2</sup></em> = 18%; <em>P</em> = 0.002). Similar results were also found for acupuncture’s relief of insomnia. The reported adverse effects of acupuncture therapy were mild and transient. For most of the subgroup analyses, acupuncture type, scale type, and the course of treatment did not show a significant relative effect.</div></div><div><h3>Conclusion</h3><div>Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD. But the certainty of evidence was very low. More high-quality, well designed, large-scale studies with long-term follow-up are needed in the future.</div><div>Pleas","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 471-491"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-06-21DOI: 10.1016/j.joim.2025.06.006
Bo Jiang , Zhao-yang Meng , Yu-jie Hu , Jun-jun Chen , Ling Zong , Ling-yan Xu , Xiang-qi Zhang , Jing-xian Zhang , Yong-long Han
Objective
Huachansu injection (HCSI), a promising anti-cancer Chinese medicine injection, has been reported to have the potential for reducing the toxicity of chemotherapy and improving the quality of life for colorectal cancer (CRC) patients. The objective of this study is to explore the synergistic and detoxifying effects of HCSI when used in combination with irinotecan (CPT-11).
Methods
To investigate the effect of HCSI on anti-CRC efficacy and intestinal toxicity of CPT-11, we measured changes in the biological behavior of LoVo cells in vitro, and anti-tumor effects in LoVo cell xenograft nude mice models in vivo. Meanwhile, the effect of HCSI on intestinal toxicity and the uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) expression was investigated in the CPT-11-induced colitis mouse model. Subsequently, we measured the effect of HCSI and its 13 constituent bufadienolides on the expression of UGT1A1 and organic anion transporting polypeptides 1B3 (OATP1B3) in HepG2 cells.
Results
The combination index (CI) results showed that the combination of HCSI and CPT-11 exhibited a synergistic effect (CI < 1), which significantly suppressing the LoVo cell migration, enhancing G2/M and S phase arrest, and inhibiting tumor growth in vivo. Additionally, the damage to intestinal tissues was attenuated by HCSI in CPT-11-induced colitis model, while the increased expression of UGT1A1 in HepG2 cells and in mouse was observed.
Conclusion
The co-therapy with HCSI alleviated the intestinal toxicity induced by CPT-11 and exerted an enhanced anti-CRC effect. The detoxifying mechanism may be related to the increased expression of UGT1A1 and OATP1B3 by HCSI and its bufadienolides components. The findings of this study may serve as a theoretical insights and strategies to improve CRC patient outcomes. Please cite this article as: Jiang B, Meng ZY, Hu YJ, Chen JJ, Zong L, Xu LY, Zhang XQ, Zhang JX, Han YL. Huachansu injection enhances anti-colorectal cancer efficacy of irinotecan and alleviates its induced intestinal toxicity through upregulating UGT1A1-OATP1B3 expression in vitro and in vivo. J Integr Med. 2025; 23(5):576–590.
{"title":"Huachansu injection enhances anti-colorectal cancer efficacy of irinotecan and alleviates its induced intestinal toxicity through upregulating UGT1A1-OATP1B3 expression in vitro and in vivo","authors":"Bo Jiang , Zhao-yang Meng , Yu-jie Hu , Jun-jun Chen , Ling Zong , Ling-yan Xu , Xiang-qi Zhang , Jing-xian Zhang , Yong-long Han","doi":"10.1016/j.joim.2025.06.006","DOIUrl":"10.1016/j.joim.2025.06.006","url":null,"abstract":"<div><h3>Objective</h3><div><span>Huachansu injection (HCSI), a promising anti-cancer Chinese medicine injection, has been reported to have the potential for reducing the toxicity of chemotherapy and improving the quality of life for </span>colorectal cancer<span> (CRC) patients. The objective of this study is to explore the synergistic and detoxifying effects of HCSI when used in combination with irinotecan (CPT-11).</span></div></div><div><h3>Methods</h3><div><span><span>To investigate the effect of HCSI on anti-CRC efficacy and intestinal toxicity of CPT-11, we measured changes in the biological behavior of LoVo cells in vitro, and anti-tumor effects in LoVo cell xenograft </span>nude mice<span> models in vivo. Meanwhile, the effect of HCSI on intestinal toxicity and the uridine diphosphate-glucuronosyltransferase 1A1 (UGT1A1) expression was investigated in the CPT-11-induced colitis mouse model. Subsequently, we measured the effect of HCSI and its 13 constituent </span></span>bufadienolides<span> on the expression of UGT1A1 and organic anion transporting polypeptides 1B3 (OATP1B3) in HepG2 cells.</span></div></div><div><h3>Results</h3><div>The combination index (CI) results showed that the combination of HCSI and CPT-11 exhibited a synergistic effect (CI < 1), which significantly suppressing the LoVo cell migration, enhancing G2/M and S phase arrest, and inhibiting tumor growth in vivo. Additionally, the damage to intestinal tissues was attenuated by HCSI in CPT-11-induced colitis model, while the increased expression of UGT1A1 in HepG2 cells and in mouse was observed.</div></div><div><h3>Conclusion</h3><div>The co-therapy with HCSI alleviated the intestinal toxicity induced by CPT-11 and exerted an enhanced anti-CRC effect. The detoxifying mechanism may be related to the increased expression of UGT1A1 and OATP1B3 by HCSI and its bufadienolides components. The findings of this study may serve as a theoretical insights and strategies to improve CRC patient outcomes. Please cite this article as: Jiang B, Meng ZY, Hu YJ, Chen JJ, Zong L, Xu LY, Zhang XQ, Zhang JX, Han YL. Huachansu injection enhances anti-colorectal cancer efficacy of irinotecan and alleviates its induced intestinal toxicity through upregulating UGT1A1-OATP1B3 expression in vitro and in vivo. <em>J Integr Med</em>. 2025; 23(5):576–590.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 576-590"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-07-28DOI: 10.1016/j.joim.2025.07.008
Hui-xian Wang , Xin-tong Yu , Jing Hu , Jin-jia Chen , Yu-ting Mei , Yun-fei Chen
<div><h3>Background</h3><div>Electroacupuncture (EA) may affect the severity of hot flashes (HFs) associated with natural menopause and provide additional benefits for postmenopausal women. However, the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.</div></div><div><h3>Objective</h3><div>We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.</div></div><div><h3>Design, setting, participants and interventions</h3><div>This randomized sham-controlled trial involved 72 women with HFs. The participants were divided equally into the intervention and control groups. The intervention group was treated with EA, while the control group was treated with sham acupuncture. The main acupoints used were Hegu (LI4), Guanyuan (RN4), Sanyinjiao (SP6), Taixi (KI3), Fuliu (KI7) and Shenshu (BL23). All participants received 18 treatment sessions, distributed across a 6-week period. The treatment was administered on three occasions per week, adhering to a fixed weekday schedule (Monday, Wednesday, Friday or Tuesday, Thursday, Saturday) with a minimum interval of one day between sessions. Each patient received a 12-week follow-up.</div></div><div><h3>Main outcome measures</h3><div>The HF score was the primary outcome. Participants documented the frequency and severity of HFs in a 7-day symptom diary, which provided data for calculating the HF score. Secondary outcomes were the Menopause Rating Scale (MRS), Menopause-Specific Quality of Life Questionnaire (MENQOL), Pittsburgh Sleep Quality Index (PSQI) and Traditional Chinese Medicine Syndrome Score Scale (TCMSSS), as well as estradiol (E<sub>2</sub>), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up (<em>P</em> < 0.001). Immediately after completion of the 6-week treatment cycle and at 12 weeks post-intervention, the HF scores were similar in both groups. At week 6, the intervention group showed significantly greater improvements in MRS, MENQOL (vasomotor, psychosocial, and physical), PSQI and TCMSSS scores (<em>P</em> < 0.05). The improvements in the MENQOL (vasomotor, and psychosocial) and PSQI total scores persisted through the follow-up (<em>P</em> < 0.05). However, the results showed no significant inter- or intragroup differences in sexual scores on the MENQOL (<em>P</em> > 0.05). EA did not significantly decrease E<sub>2</sub>, LH or FSH levels compared to placebo. The incidence of adverse events was similar in both groups.</div></div><div><h3>Conclusion</h3><div>EA does not significantly improve HFs in early postmenopausal patients. However, it enhances the quality of sleep and decreases menopausal symptoms across vasomotor, psychosocial and physical domains.</div><div><em>Trial registration</em>: Chinese Clinical Trial Regist
{"title":"Electroacupuncture for hot flashes in early menopause: A randomized sham-controlled trial","authors":"Hui-xian Wang , Xin-tong Yu , Jing Hu , Jin-jia Chen , Yu-ting Mei , Yun-fei Chen","doi":"10.1016/j.joim.2025.07.008","DOIUrl":"10.1016/j.joim.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Electroacupuncture (EA) may affect the severity of hot flashes (HFs) associated with natural menopause and provide additional benefits for postmenopausal women. However, the evidence for its effectiveness in the management of early postmenopausal HFs remains inadequately understood.</div></div><div><h3>Objective</h3><div>We designed this trial to assess the efficacy and safety of EA for relieving early postmenopausal HFs.</div></div><div><h3>Design, setting, participants and interventions</h3><div>This randomized sham-controlled trial involved 72 women with HFs. The participants were divided equally into the intervention and control groups. The intervention group was treated with EA, while the control group was treated with sham acupuncture. The main acupoints used were Hegu (LI4), Guanyuan (RN4), Sanyinjiao (SP6), Taixi (KI3), Fuliu (KI7) and Shenshu (BL23). All participants received 18 treatment sessions, distributed across a 6-week period. The treatment was administered on three occasions per week, adhering to a fixed weekday schedule (Monday, Wednesday, Friday or Tuesday, Thursday, Saturday) with a minimum interval of one day between sessions. Each patient received a 12-week follow-up.</div></div><div><h3>Main outcome measures</h3><div>The HF score was the primary outcome. Participants documented the frequency and severity of HFs in a 7-day symptom diary, which provided data for calculating the HF score. Secondary outcomes were the Menopause Rating Scale (MRS), Menopause-Specific Quality of Life Questionnaire (MENQOL), Pittsburgh Sleep Quality Index (PSQI) and Traditional Chinese Medicine Syndrome Score Scale (TCMSSS), as well as estradiol (E<sub>2</sub>), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant reductions in HF scores after the treatment and during the follow-up (<em>P</em> < 0.001). Immediately after completion of the 6-week treatment cycle and at 12 weeks post-intervention, the HF scores were similar in both groups. At week 6, the intervention group showed significantly greater improvements in MRS, MENQOL (vasomotor, psychosocial, and physical), PSQI and TCMSSS scores (<em>P</em> < 0.05). The improvements in the MENQOL (vasomotor, and psychosocial) and PSQI total scores persisted through the follow-up (<em>P</em> < 0.05). However, the results showed no significant inter- or intragroup differences in sexual scores on the MENQOL (<em>P</em> > 0.05). EA did not significantly decrease E<sub>2</sub>, LH or FSH levels compared to placebo. The incidence of adverse events was similar in both groups.</div></div><div><h3>Conclusion</h3><div>EA does not significantly improve HFs in early postmenopausal patients. However, it enhances the quality of sleep and decreases menopausal symptoms across vasomotor, psychosocial and physical domains.</div><div><em>Trial registration</em>: Chinese Clinical Trial Regist","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 519-527"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-07-18DOI: 10.1016/j.joim.2025.07.005
Yue Jiang , Claire Chenwen Zhong , Betty Huan Wang , Shan-shan Xu , Fai Fai Ho , Ming Hong Kwong , Leonard Ho , Joson Hao-Shen Zhou , K.C. Lam , Jian-ping Liu , Bao-ting Zhang , Vincent Chi Ho Chung
Objective
This cross-sectional study assessed the methodological quality of systematic reviews (SRs) of Chinese herbal medicine (CHM) published in Chinese between Jan 2021 and Sep 2022.
Methods
Chinese language CHM SRs were identified through literature searches across 3 international and 4 Chinese databases. Methodological quality was appraised using A MeaSurement Tool to Assess systematic Reviews 2. Logistic regressions were used to explore associations between bibliographical characteristics and quality.
Results
Analyses of methodological quality found that among the 213 sampled SRs, 69.5% were of critically low quality, 30.5% were of low quality, and none achieved high or moderate quality. Common shortcomings included the failure to identify the studies excluded from the analysis, failure to disclose funding sources, and limited evaluation of the potential impact of bias on conclusions. Logistic regressions revealed that SRs led by corresponding authors affiliated with universities or academic institutions tended to be of lower quality than SRs led by authors affiliated with hospitals or clinical facilities.
Conclusion
Recent Chinese language CHM SRs exhibited limited methodological quality, making them unlikely to support the development of clinical practice guidelines. Urgent initiatives are needed to enhance training for researchers, peer-reviewers and editors involved in the preparation and publication of SRs. Adoption of Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines in Chinese language journals is crucial to improve the relevance of SRs for Chinese medicine development. Addressing deficiencies in methodology and reporting is essential for promoting evidence-based practices and informed clinical decisions in Chinese medicine.
Please cite this article as: Jiang Y, Zhong CC, Wang BH, Xu SS, Ho FF, Kwong MH, Ho L, Zhou JHS, Lam KC, Liu JP, Zhang BT, Chung VCH. Methodological quality of systematic reviews on orally administered Chinese herbal medicine published in Chinese between 2021 and 2022: A cross-sectional study. J Integr Med. 2025; 23(5):492–501.
{"title":"Methodological quality of systematic reviews on orally administered Chinese herbal medicine published in Chinese between 2021 and 2022: A cross-sectional study","authors":"Yue Jiang , Claire Chenwen Zhong , Betty Huan Wang , Shan-shan Xu , Fai Fai Ho , Ming Hong Kwong , Leonard Ho , Joson Hao-Shen Zhou , K.C. Lam , Jian-ping Liu , Bao-ting Zhang , Vincent Chi Ho Chung","doi":"10.1016/j.joim.2025.07.005","DOIUrl":"10.1016/j.joim.2025.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>This cross-sectional study assessed the methodological quality of systematic reviews (SRs) of Chinese herbal medicine (CHM) published in Chinese between Jan 2021 and Sep 2022.</div></div><div><h3>Methods</h3><div>Chinese language CHM SRs were identified through literature searches across 3 international and 4 Chinese databases. Methodological quality was appraised using A MeaSurement Tool to Assess systematic Reviews 2. Logistic regressions were used to explore associations between bibliographical characteristics and quality.</div></div><div><h3>Results</h3><div>Analyses of methodological quality found that among the 213 sampled SRs, 69.5% were of critically low quality, 30.5% were of low quality, and none achieved high or moderate quality. Common shortcomings included the failure to identify the studies excluded from the analysis, failure to disclose funding sources, and limited evaluation of the potential impact of bias on conclusions. Logistic regressions revealed that SRs led by corresponding authors affiliated with universities or academic institutions tended to be of lower quality than SRs led by authors affiliated with hospitals or clinical facilities.</div></div><div><h3>Conclusion</h3><div>Recent Chinese language CHM SRs exhibited limited methodological quality, making them unlikely to support the development of clinical practice guidelines. Urgent initiatives are needed to enhance training for researchers, peer-reviewers and editors involved in the preparation and publication of SRs. Adoption of Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines in Chinese language journals is crucial to improve the relevance of SRs for Chinese medicine development. Addressing deficiencies in methodology and reporting is essential for promoting evidence-based practices and informed clinical decisions in Chinese medicine.</div><div><br>Please cite this article as: Jiang Y, Zhong CC, Wang BH, Xu SS, Ho FF, Kwong MH, Ho L, Zhou JHS, Lam KC, Liu JP, Zhang BT, Chung VCH. Methodological quality of systematic reviews on orally administered Chinese herbal medicine published in Chinese between 2021 and 2022: A cross-sectional study. <em>J Integr Med</em>. 2025; 23(5):492–501.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 492-501"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-14DOI: 10.1016/j.joim.2025.07.003
Hui-Min Yang, Jun Chang, Jin-Rong Wu, Qiao-Qiao Hu, Chen-Liu Zhang, Yao Zou, Yun-Yun Yan, Yi Guo, Dan Zhou
Objective: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease that is both prevalent and preventable. Effective detection and treatment at an early stage are crucial for delaying the progression of COPD and improving patient outcomes. However, early diagnosis of COPD is still a great challenge for modern medicine, and further research is needed to address this issue.
Methods: In this study, rat models of COPD were employed to examine the alterations in blood perfusion at Feishu (BL13) on the body surface, as well as at control non-acupoints and other meridian points (Taichong, Yanglingquan and Zusanli), throughout the course of COPD onset, establishment and improvement. Correlations between lung pathology (levels of mean linear intercept, bronchitis scores, interleukin-1β and interleukin-6) and blood perfusion at BL13, control non-acupoints, Taichong and Yanglingquan were analyzed.
Results: The findings revealed that blood perfusion specifically at BL13 increased with the progression of COPD, while it decreased during disease recovery. Compared with other monitoring points, the blood perfusion at BL13 had more positive correlations with lung pathological changes, which is consistent with the trend of disease severity.
Conclusion: Blood perfusion at BL13, a traditional Chinese medicine diagnostic method, may serve as an early warning biomarker for COPD. Therefore, utilizing this approach could aid in the early detection of COPD. Please cite this article as: Yang HM, Chang J, Wu JR, Hu QQ, Zhang CL, Zou Y, et al. Blood perfusion at Feishu (BL13): A potential early warning biomarker for chronic obstructive pulmonary disease. J Integr Med. 2025; Epub ahead of print.
{"title":"Blood perfusion at Feishu (BL13): A potential early warning biomarker for chronic obstructive pulmonary disease.","authors":"Hui-Min Yang, Jun Chang, Jin-Rong Wu, Qiao-Qiao Hu, Chen-Liu Zhang, Yao Zou, Yun-Yun Yan, Yi Guo, Dan Zhou","doi":"10.1016/j.joim.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.joim.2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease that is both prevalent and preventable. Effective detection and treatment at an early stage are crucial for delaying the progression of COPD and improving patient outcomes. However, early diagnosis of COPD is still a great challenge for modern medicine, and further research is needed to address this issue.</p><p><strong>Methods: </strong>In this study, rat models of COPD were employed to examine the alterations in blood perfusion at Feishu (BL13) on the body surface, as well as at control non-acupoints and other meridian points (Taichong, Yanglingquan and Zusanli), throughout the course of COPD onset, establishment and improvement. Correlations between lung pathology (levels of mean linear intercept, bronchitis scores, interleukin-1β and interleukin-6) and blood perfusion at BL13, control non-acupoints, Taichong and Yanglingquan were analyzed.</p><p><strong>Results: </strong>The findings revealed that blood perfusion specifically at BL13 increased with the progression of COPD, while it decreased during disease recovery. Compared with other monitoring points, the blood perfusion at BL13 had more positive correlations with lung pathological changes, which is consistent with the trend of disease severity.</p><p><strong>Conclusion: </strong>Blood perfusion at BL13, a traditional Chinese medicine diagnostic method, may serve as an early warning biomarker for COPD. Therefore, utilizing this approach could aid in the early detection of COPD. Please cite this article as: Yang HM, Chang J, Wu JR, Hu QQ, Zhang CL, Zou Y, et al. Blood perfusion at Feishu (BL13): A potential early warning biomarker for chronic obstructive pulmonary disease. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-22DOI: 10.1016/j.joim.2025.05.004
Yan Han , Yu Wang , Mo-yi Shi , Yu Liu , Xiao-dong Cheng , Yang Zhou
Objective
The concept of constitution in traditional Chinese medicine (TCM) has been increasingly recognized as a crucial factor in both the prevention and treatment of insomnia. However, rigorous statistical evidence on the correlation between TCM constitutions—particularly mixed constitutions—and insomnia disorder remains limited. This study aimed to investigate the association between specific TCM constitutions and insomnia disorder.
Methods
A cross-sectional study was conducted at the Department of Preventive Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, from November 2022 to December 2023. TCM constitutions were assessed using the Constitution in Chinese Medicine Questionnaire. Insomnia disorder was diagnosed by experienced internal medicine physicians according to the criteria of the International Classification of Sleep Disorders, Third Edition. A total of 1065 eligible participants (242 with insomnia disorder and 823 controls) were included in the final analysis.
Results
Among the participants, 862 (80.94%) exhibited biased constitutions, with 75.30% of these having mixed constitutions. Logistic regression analysis revealed a negative association between the gentleness constitution and insomnia disorder, whereas qi-deficiency, yang-deficiency, phlegm-dampness and qi-depression constitutions were positively associated with insomnia disorder. These associations remained significant after adjusting for potential confounders and were further validated through sensitivity analysis using propensity score matching.
Conclusion
Significant associations between TCM constitutions and insomnia disorder were demonstrated. Future research should further investigate these relationships and explore the underlying mechanisms through rigorous longitudinal and interventional studies to improve understanding and clinical applications.
Please cite this article as: Han Y, Wang Y, Shi MY, Liu Y, Cheng XD, Zhou Y. Integrating traditional Chinese medicine constitutions into insomnia management: Findings from a cross-sectional study. J Integr Med. 2025; 23(4): 382–389.
{"title":"Integrating traditional Chinese medicine constitutions into insomnia management: Findings from a cross-sectional study","authors":"Yan Han , Yu Wang , Mo-yi Shi , Yu Liu , Xiao-dong Cheng , Yang Zhou","doi":"10.1016/j.joim.2025.05.004","DOIUrl":"10.1016/j.joim.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>The concept of constitution in traditional Chinese medicine (TCM) has been increasingly recognized as a crucial factor in both the prevention and treatment of insomnia. However, rigorous statistical evidence on the correlation between TCM constitutions—particularly mixed constitutions—and insomnia disorder remains limited. This study aimed to investigate the association between specific TCM constitutions and insomnia disorder.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at the Department of Preventive Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, from November 2022 to December 2023. TCM constitutions were assessed using the Constitution in Chinese Medicine Questionnaire. Insomnia disorder was diagnosed by experienced internal medicine physicians according to the criteria of the <em>International Classification of Sleep Disorders</em>, <em>Third Edition</em>. A total of 1065 eligible participants (242 with insomnia disorder and 823 controls) were included in the final analysis.</div></div><div><h3>Results</h3><div>Among the participants, 862 (80.94%) exhibited biased constitutions, with 75.30% of these having mixed constitutions. Logistic regression analysis revealed a negative association between the gentleness constitution and insomnia disorder, whereas qi-deficiency, yang-deficiency, phlegm-dampness and qi-depression constitutions were positively associated with insomnia disorder. These associations remained significant after adjusting for potential confounders and were further validated through sensitivity analysis using propensity score matching.</div></div><div><h3>Conclusion</h3><div>Significant associations between TCM constitutions and insomnia disorder were demonstrated. Future research should further investigate these relationships and explore the underlying mechanisms through rigorous longitudinal and interventional studies to improve understanding and clinical applications.</div><div>Please cite this article as: Han Y, Wang Y, Shi MY, Liu Y, Cheng XD, Zhou Y. Integrating traditional Chinese medicine constitutions into insomnia management: Findings from a cross-sectional study. <em>J Integr Med</em>. 2025; 23(4): 382–389.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 4","pages":"Pages 382-389"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-05-10DOI: 10.1016/j.joim.2025.05.001
Jia Wen Chin , Rafidah Abdullah , Benjamin Wei Wang Tan , Koh Wei Wong , Ban-Hock Khor
<div><h3>Background</h3><div>The use of complementary and alternative medicine (CAM) is common among individuals with underlying chronic illnesses.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease (CKD).</div></div><div><h3>Search strategy</h3><div>PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.</div></div><div><h3>Inclusion criteria</h3><div>Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.</div></div><div><h3>Data extraction and analysis</h3><div>Two independent reviewers performed the literature screening. The data were extracted from the included studies by one reviewer and cross-checked by another. Discrepancies were resolved by discussion and consensus among two reviewers. Primary information included prevalence of CAM use, types of CAM used, reasons for CAM use, factors associated with CAM use, and disclosure to healthcare providers. Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.</div></div><div><h3>Results</h3><div>Forty-one studies were included in this systematic review and meta-analysis. The pooled prevalence of CAM use was 43% (95% confidence interval: 34%, 51%), <em>I</em><sup>2</sup> = 99.46%. The reasons for CAM use included treatment of underlying comorbidities, complications or symptoms, maintenance of general health, and treatment of CKD. Nutritional approaches were the most common CAM modality, with 412 different herbal and dietary supplements reported; psychological and physical approaches included massage therapy, relaxation techniques, and mind–body practices; and other complementary health approaches such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine were also frequently reported. Factors associated with CAM use included sociodemographic characteristics such as older age, female gender, or higher income; disease or therapy factors such as not having diabetes, relying on hemodialysis, or poor adherence to medication; and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM. About 66% (61%, 72%) of CAM users did not disclose the use of CAM to their healthcare providers.</div></div><div><h3>Conclusion</h3><div>CAM use is prevalent among individuals with CKD, and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm.</div><div>Please cite this article as: Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis. <em>J Inte
背景：补充和替代医学（CAM）的使用是常见的个体与潜在的慢性疾病。目的：本系统综述和荟萃分析调查了慢性肾脏疾病（CKD）患者中CAM的全球患病率和使用模式。检索策略：检索PubMed， Embase和护理和联合健康文献累积索引Plus，从创建到2024年2月26日。纳入标准：在18岁以上CKD所有阶段或接受任何形式肾脏替代治疗的患者中至少使用一种CAM的原创文章。资料提取和分析：两位独立的审稿人进行文献筛选。数据由一位审稿人从纳入的研究中提取，并由另一位审稿人进行交叉检查。差异通过两位审稿人的讨论和共识得到解决。主要信息包括辅助手段使用的流行程度、使用的辅助手段类型、使用的原因、与辅助手段使用相关的因素以及向医疗保健提供者披露的情况。采用随机效应模型进行meta分析，以确定CAM使用和不披露的总流行率。结果：41项研究被纳入本系统综述和荟萃分析。CAM使用的总患病率为43%(95%可信区间：34%，51%),I2 = 99.46%。使用CAM的原因包括治疗潜在的合并症、并发症或症状、维持一般健康和治疗慢性肾病。营养方法是最常见的辅助治疗方式，共报告了412种不同的草药和膳食补充剂；心理和物理方法包括按摩疗法、放松技巧和身心练习；以及其他辅助保健方法，如顺势疗法、传统中医和阿育吠陀医学，也经常被报道。与辅助治疗使用相关的因素包括社会人口统计学特征，如年龄较大、女性性别或收入较高；疾病或治疗因素，如没有糖尿病，依赖血液透析，或药物依从性差；患者或内部因素，如对CAM的积极态度和认知CAM的安全性。约66%（61%,72%）的CAM使用者没有向其医疗保健提供者披露使用CAM的情况。结论：慢性肾病患者普遍使用CAM，医护人员应公开有效沟通，强调CAM的合理使用，避免潜在危害。本文署名：Chin JW， Abdullah R, Tan BWW, Wong KW, Khor BH。成人慢性肾病患者补充和替代药物使用的患病率和模式：一项系统回顾和荟萃分析集成医学[J]；打印前Epub。
{"title":"Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis","authors":"Jia Wen Chin , Rafidah Abdullah , Benjamin Wei Wang Tan , Koh Wei Wong , Ban-Hock Khor","doi":"10.1016/j.joim.2025.05.001","DOIUrl":"10.1016/j.joim.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>The use of complementary and alternative medicine (CAM) is common among individuals with underlying chronic illnesses.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease (CKD).</div></div><div><h3>Search strategy</h3><div>PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.</div></div><div><h3>Inclusion criteria</h3><div>Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.</div></div><div><h3>Data extraction and analysis</h3><div>Two independent reviewers performed the literature screening. The data were extracted from the included studies by one reviewer and cross-checked by another. Discrepancies were resolved by discussion and consensus among two reviewers. Primary information included prevalence of CAM use, types of CAM used, reasons for CAM use, factors associated with CAM use, and disclosure to healthcare providers. Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.</div></div><div><h3>Results</h3><div>Forty-one studies were included in this systematic review and meta-analysis. The pooled prevalence of CAM use was 43% (95% confidence interval: 34%, 51%), <em>I</em><sup>2</sup> = 99.46%. The reasons for CAM use included treatment of underlying comorbidities, complications or symptoms, maintenance of general health, and treatment of CKD. Nutritional approaches were the most common CAM modality, with 412 different herbal and dietary supplements reported; psychological and physical approaches included massage therapy, relaxation techniques, and mind–body practices; and other complementary health approaches such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine were also frequently reported. Factors associated with CAM use included sociodemographic characteristics such as older age, female gender, or higher income; disease or therapy factors such as not having diabetes, relying on hemodialysis, or poor adherence to medication; and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM. About 66% (61%, 72%) of CAM users did not disclose the use of CAM to their healthcare providers.</div></div><div><h3>Conclusion</h3><div>CAM use is prevalent among individuals with CKD, and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm.</div><div>Please cite this article as: Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis. <em>J Inte","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 4","pages":"Pages 370-381"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-06-14DOI: 10.1016/j.joim.2025.06.003
Xiao-jie Li , Le Chang , Yang Mi , Ge Zhang , Shan-shan Zhu , Yue-xiao Zhang , Hao-yu Wang , Yi-shuang Lu , Ye-xuan Ping , Peng-yuan Zheng , Xia Xue
Objective
Circadian rhythm disruption (CRD) is a risk factor that correlates with poor prognosis across multiple tumor types, including hepatocellular carcinoma (HCC). However, its mechanism remains unclear. This study aimed to define HCC subtypes based on CRD and explore their individual heterogeneity.
Methods
To quantify CRD, the HCC CRD score (HCCcrds) was developed. Using machine learning algorithms, we identified CRD module genes and defined CRD-related HCC subtypes in The Cancer Genome Atlas liver HCC cohort (n = 369), and the robustness of this method was validated. Furthermore, we used bioinformatics tools to investigate the cellular heterogeneity across these CRD subtypes.
Results
We defined three distinct HCC subtypes that exhibit significant heterogeneity in prognosis. The CRD-related subtype with high HCCcrds was significantly correlated with worse prognosis, higher pathological grade, and advanced clinical stages, while the CRD-related subtype with low HCCcrds had better clinical outcomes. We also identified novel biomarkers for each subtype, such as nicotinamide n-methyltransferase and myristoylated alanine-rich protein kinase C substrate-like 1.
Conclusion
We classify the HCC patients into three distinct groups based on circadian rhythm and identify their specific biomarkers. Within these groups greater HCCcrds was associated with worse prognosis. This approach has the potential to improve prediction of an individual’s prognosis, guide precision treatments, and assist clinical decision making for HCC patients.
Please cite this article as: Li XJ, Chang L, Mi Y, Zhang G, Zhu SS, Zhang YX, et al. Integrated-omics analysis defines subtypes of hepatocellular carcinoma based on circadian rhythm. J Integr Med. 2025; 23(4): 445–456.
目的：昼夜节律紊乱（CRD）是多种肿瘤类型中与预后不良相关的危险因素，包括肝细胞癌（HCC）。然而，其机制尚不清楚。本研究旨在基于CRD定义HCC亚型，并探讨其个体异质性。方法：采用HCC CRD评分法（HCCcrds）量化CRD。使用机器学习算法，我们在The Cancer Genome Atlas liver HCC队列（n = 369）中鉴定了CRD模块基因并定义了CRD相关的HCC亚型，并验证了该方法的稳健性。此外，我们使用生物信息学工具来研究这些CRD亚型的细胞异质性。结果：我们定义了三种不同的HCC亚型，它们在预后方面表现出显著的异质性。高HCCcrds的crd相关亚型与预后差、病理分级高、临床分期进展显著相关，而低HCCcrds的crd相关亚型具有较好的临床预后。我们还为每个亚型确定了新的生物标志物，如烟酰胺n-甲基转移酶和肉豆浆酰化富丙氨酸蛋白激酶C底物样1。结论：我们根据肝细胞癌患者的昼夜节律将其分为三组，并确定了他们的特异性生物标志物。在这些组中，HCCcrds越大，预后越差。这种方法有可能改善个体预后的预测，指导精确治疗，并协助HCC患者的临床决策。本文请注明：李晓军，常丽，米莹，张刚，朱世生，张永祥，等。综合组学分析根据昼夜节律定义肝细胞癌的亚型。集成医学[J]；打印前Epub。
{"title":"Integrated-omics analysis defines subtypes of hepatocellular carcinoma based on circadian rhythm","authors":"Xiao-jie Li , Le Chang , Yang Mi , Ge Zhang , Shan-shan Zhu , Yue-xiao Zhang , Hao-yu Wang , Yi-shuang Lu , Ye-xuan Ping , Peng-yuan Zheng , Xia Xue","doi":"10.1016/j.joim.2025.06.003","DOIUrl":"10.1016/j.joim.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Circadian rhythm disruption (CRD) is a risk factor that correlates with poor prognosis across multiple tumor types, including hepatocellular carcinoma (HCC). However, its mechanism remains unclear. This study aimed to define HCC subtypes based on CRD and explore their individual heterogeneity.</div></div><div><h3>Methods</h3><div>To quantify CRD, the HCC CRD score (HCCcrds) was developed. Using machine learning algorithms, we identified CRD module genes and defined CRD-related HCC subtypes in <em>The Cancer Genome Atlas</em> liver HCC cohort (<em>n</em> = 369), and the robustness of this method was validated. Furthermore, we used bioinformatics tools to investigate the cellular heterogeneity across these CRD subtypes.</div></div><div><h3>Results</h3><div>We defined three distinct HCC subtypes that exhibit significant heterogeneity in prognosis. The CRD-related subtype with high HCCcrds was significantly correlated with worse prognosis, higher pathological grade, and advanced clinical stages, while the CRD-related subtype with low HCCcrds had better clinical outcomes. We also identified novel biomarkers for each subtype, such as nicotinamide n-methyltransferase and myristoylated alanine-rich protein kinase C substrate-like 1.</div></div><div><h3>Conclusion</h3><div>We classify the HCC patients into three distinct groups based on circadian rhythm and identify their specific biomarkers. Within these groups greater HCCcrds was associated with worse prognosis. This approach has the potential to improve prediction of an individual’s prognosis, guide precision treatments, and assist clinical decision making for HCC patients.</div><div>Please cite this article as: Li XJ, Chang L, Mi Y, Zhang G, Zhu SS, Zhang YX, et al. Integrated-omics analysis defines subtypes of hepatocellular carcinoma based on circadian rhythm. <em>J Integr Med</em>. 2025; 23(4): 445–456.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 4","pages":"Pages 445-456"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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