Pub Date : 2025-05-01DOI: 10.1016/j.joim.2025.03.005
Hang Zhao , Xin Ma , Hao Wang , Xiao-jie Ding , Le Kuai , Jian-kun Song , Zhan Zhang , Dan Yang , Chun-jie Gao , Bin Li , Mi Zhou
Objective
To assess the safety and topical efficacy of prim-O-glucosylcimifugin (POG) and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis (AD).
Methods
The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Subsequently, the impact of POG on the differentiation of cluster of differentiation (CD) 4+ T cell subsets, including T-helper type (Th) 1, Th2, Th17, and regulatory T (Treg), was examined through in vitro experiments. Network pharmacology analysis was used to elucidate POG’s therapeutic mechanisms. Furthermore, the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD. The protein and transcript levels of inflammatory markers, including cytokines, lymphocyte-specific protein tyrosine kinase (Lck) mRNA, and LCK phosphorylation (p-LCK), were quantified using immunohistochemistry, RT-qPCR, and Western blot analysis.
Results
POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4 (Il4) and Il13 mRNA. In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells, whereas it exerted negligible influence on the differentiation of Th1, Th17 and Treg cells. Network pharmacology identified LCK as a key therapeutic target of POG. Moreover, the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver, kidney or spleen tissues. POG significantly reduced the levels of Il4, Il5, Il13, and thymic stromal lymphopoietin (Tslp) mRNA in the AD mice. Concurrently, POG enhanced the expression of p-LCK protein and Lck mRNA.
Conclusion
Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation.
Please cite this article as: Zhao H, Ma X, Wang H, Ding XJ, Kuai L, Song JK, Zhang Z, Yang D, Gao CJ, Li B, Zhou M. Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation. J Integr Med. 2025; 23(3): 309–319.
{"title":"Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation","authors":"Hang Zhao , Xin Ma , Hao Wang , Xiao-jie Ding , Le Kuai , Jian-kun Song , Zhan Zhang , Dan Yang , Chun-jie Gao , Bin Li , Mi Zhou","doi":"10.1016/j.joim.2025.03.005","DOIUrl":"10.1016/j.joim.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the safety and topical efficacy of prim-O-glucosylcimifugin (POG) and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis (AD).</div></div><div><h3>Methods</h3><div>The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Subsequently, the impact of POG on the differentiation of cluster of differentiation (CD) 4<sup>+</sup> T cell subsets, including T-helper type (Th) 1, Th2, Th17, and regulatory T (Treg), was examined through in vitro experiments. Network pharmacology analysis was used to elucidate POG’s therapeutic mechanisms. Furthermore, the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD. The protein and transcript levels of inflammatory markers, including cytokines, lymphocyte-specific protein tyrosine kinase (<em>Lck</em>) mRNA, and LCK phosphorylation (p-LCK), were quantified using immunohistochemistry, RT-qPCR, and Western blot analysis.</div></div><div><h3>Results</h3><div>POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4 (<em>Il4</em>) and <em>Il13</em> mRNA. In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells, whereas it exerted negligible influence on the differentiation of Th1, Th17 and Treg cells. Network pharmacology identified LCK as a key therapeutic target of POG. Moreover, the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver, kidney or spleen tissues. POG significantly reduced the levels of <em>Il4</em>, <em>Il5</em>, <em>Il13,</em> and thymic stromal lymphopoietin (<em>Tslp</em>) mRNA in the AD mice. Concurrently, POG enhanced the expression of p-LCK protein and <em>Lck</em> mRNA.</div></div><div><h3>Conclusion</h3><div>Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation.</div><div>Please cite this article as: Zhao H, Ma X, Wang H, Ding XJ, Kuai L, Song JK, Zhang Z, Yang D, Gao CJ, Li B, Zhou M. Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation. <em>J Integr Med</em>. 2025; 23(3): 309–319.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 3","pages":"Pages 309-319"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064965","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}
Prunella vulgaris L. has long been used for liver protection according to traditional Chinese medicine theory and has been proven by modern pharmacological research to have multiple potential liver-protective effects. However, its effects on non-alcoholic steatohepatitis (NASH) are currently uncertain. Our study explores the effects of P. vulgaris polysaccharides on NASH and intestinal homeostasis.
Methods
An aqueous extract of the dried fruit spikes of P. vulgaris was precipitated in an 85% ethanol solution (PVE85) to extract crude polysaccharides from the herb. A choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD) was administrated to male C57BL/6 mice to establish a NASH animal model. After 4 weeks, the PVE85 group was orally administered PVE85 (200 mg/[kg·d]), while the control group and CDAHFD group were orally administered vehicle for 6 weeks. Quantitative real-time polymerase chain reaction analysis, Western blotting, immunohistochemistry and other methods were used to assess the impact of PVE85 on the liver in mice with NASH. 16S rRNA gene amplicon analysis was employed to evaluate the gut microbiota abundance and diversity in each group to examine alterations at various taxonomic levels.
Results
PVE85 significantly reversed the course of NASH in mice. mRNA levels of inflammatory mediators associated with NASH and protein expression of hepatic nucleotide-binding leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) were significantly reduced after PVE85 treatment. Moreover, PVE85 attenuated the thickening and cross-linking of collagen fibres and inhibited the expression of fibrosis-related mRNAs in the livers of NASH mice. Intriguingly, PVE85 restored changes in the gut microbiota and improved intestinal barrier dysfunction induced by NASH by increasing the abundance of Actinobacteria and reducing the abundance of Proteobacteria at the phylum level. PVE85 had significant activity in reducing the relative abundance of Clostridiaceae at the family levels. PVE85 markedly enhanced the abundance of some beneficial micro-organisms at various taxonomic levels as well. Additionally, the physicochemical environment of the intestine was effectively improved, involving an increase in the density of intestinal villi, normalization of the intestinal pH, and improvement of intestinal permeability.
Conclusion
PVE85 can reduce hepatic lipid overaccumulation, inflammation, and fibrosis in an animal model of CDAHFD-induced NASH and improve the intestinal microbial composition and intestinal structure.
Please cite this article as: Zhu MJ, Song YJ, Rao PL, Gu WY, Xu Y, Xu HX. Therapeutic role of Prunella vulgaris L. polysaccharides in non-alcoholic steatohepatitis and gut dysbiosis. J Integr Med. 2025; 2025; 23(3): 297–308.
{"title":"Therapeutic role of Prunella vulgaris L. polysaccharides in non-alcoholic steatohepatitis and gut dysbiosis","authors":"Meng-jie Zhu , Yi-jie Song , Pei-li Rao , Wen-yi Gu , Yu Xu , Hong-xi Xu","doi":"10.1016/j.joim.2025.03.002","DOIUrl":"10.1016/j.joim.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div><em>Prunella vulgaris</em> L. has long been used for liver protection according to traditional Chinese medicine theory and has been proven by modern pharmacological research to have multiple potential liver-protective effects. However, its effects on non-alcoholic steatohepatitis (NASH) are currently uncertain. Our study explores the effects of <em>P. vulgaris</em> polysaccharides on NASH and intestinal homeostasis.</div></div><div><h3>Methods</h3><div>An aqueous extract of the dried fruit spikes of <em>P. vulgaris</em> was precipitated in an 85% ethanol solution (PVE85) to extract crude polysaccharides from the herb. A choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD) was administrated to male C57BL/6 mice to establish a NASH animal model. After 4 weeks, the PVE85 group was orally administered PVE85 (200 mg/[kg·d]), while the control group and CDAHFD group were orally administered vehicle for 6 weeks. Quantitative real-time polymerase chain reaction analysis, Western blotting, immunohistochemistry and other methods were used to assess the impact of PVE85 on the liver in mice with NASH. 16S rRNA gene amplicon analysis was employed to evaluate the gut microbiota abundance and diversity in each group to examine alterations at various taxonomic levels.</div></div><div><h3>Results</h3><div>PVE85 significantly reversed the course of NASH in mice. mRNA levels of inflammatory mediators associated with NASH and protein expression of hepatic nucleotide-binding leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) were significantly reduced after PVE85 treatment. Moreover, PVE85 attenuated the thickening and cross-linking of collagen fibres and inhibited the expression of fibrosis-related mRNAs in the livers of NASH mice. Intriguingly, PVE85 restored changes in the gut microbiota and improved intestinal barrier dysfunction induced by NASH by increasing the abundance of Actinobacteria and reducing the abundance of Proteobacteria at the phylum level. PVE85 had significant activity in reducing the relative abundance of Clostridiaceae at the family levels. PVE85 markedly enhanced the abundance of some beneficial micro-organisms at various taxonomic levels as well. Additionally, the physicochemical environment of the intestine was effectively improved, involving an increase in the density of intestinal villi, normalization of the intestinal pH, and improvement of intestinal permeability.</div></div><div><h3>Conclusion</h3><div>PVE85 can reduce hepatic lipid overaccumulation, inflammation, and fibrosis in an animal model of CDAHFD-induced NASH and improve the intestinal microbial composition and intestinal structure.</div><div>Please cite this article as: Zhu MJ, Song YJ, Rao PL, Gu WY, Xu Y, Xu HX. Therapeutic role of <em>Prunella vulgaris</em> L. polysaccharides in non-alcoholic steatohepatitis and gut dysbiosis. <em>J Integr Med</em>. 2025; 2025; 23(3): 297–308.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 3","pages":"Pages 297-308"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007260","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}
The present study investigated the cytoprotective effects of a Pogonatherum paniceum extract prepared with 80% ethanol (PPE) using synchrotron radiation-based Fourier transform infrared (SR-FTIR) microspectroscopy and determined its phytochemical profile.
Methods
The volatile and polyphenolic compounds in PPE were characterized using gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry, respectively. The antioxidant capacity of PPE was evaluated using chemical and cell-based assays. The SR-FTIR microspectroscopy was performed to evaluate the cytoprotective effect of PPE by identifying changes in macromolecule composition in tert-butyl hydroperoxide (tBuOOH)-induced oxidative damage in RAW264.7 cells.
Results
A total of 48 volatile compounds and 28 polyphenol components were found in PPE. PPE exhibited a high potential for antioxidant activity by scavenging the intracellular reactive oxygen species in tBuOOH-induced oxidative damage in RAW264.7 cells. PPE treatment also significantly protected RAW264.7 cells against tBuOOH-induced toxicity and restored cell viability. The SR-FTIR analysis revealed that tBuOOH increased the lipid and ester lipid content in RAW264.7 cells. The PPE exerted a cytoprotective effect by decreasing the levels of lipid and ester lipid compounds that had been elevated by tBuOOH in RAW264.7 cells. These findings indicate that PPE has cytoprotective potential due to its ability to inhibit endogenous reactive oxygen species.
Conclusion
This study extends the current knowledge on the phytochemistry of PPE and its antioxidant and cytoprotective effects. These findings support the use of SR-FTIR microspectroscopy to determine the cytoprotective effects of natural products. PPE extract may be a candidate compound for new therapeutics and nutraceuticals that target the prevention of oxidative stress-associated diseases.
Please cite this article as: Dunkhunthod B, Thumanu K, Teethaisong Y, Sittisart P, Sittisart P. Cytoprotective activity of Pogonatherum paniceum (Lam.) Hack. ethanolic extract evaluated by synchrotron radiation-based Fourier transform infrared microspectroscopy. J Integr Med. 2025; 23(2): 182–194.
目的：采用同步辐射傅立叶变换红外（SR-FTIR）微光谱法研究80%乙醇制备的白芍提取物的细胞保护作用，并测定其植物化学成分。方法：分别采用气相色谱-质谱法和液相色谱-质谱法对PPE中挥发物和多酚类化合物进行表征。PPE的抗氧化能力通过化学和细胞为基础的试验进行评估。采用SR-FTIR微光谱技术，通过鉴定过氧化叔丁基（tBuOOH）诱导的RAW264.7细胞氧化损伤中大分子组成的变化，评价PPE的细胞保护作用。结果：PPE中共检出48种挥发性化合物和28种多酚类成分。PPE通过清除tbuoh诱导的RAW264.7细胞氧化损伤中的细胞内活性氧，显示出较高的抗氧化活性潜力。PPE处理还能显著保护RAW264.7细胞免受tbuoh诱导的毒性，恢复细胞活力。SR-FTIR分析显示，buooh增加了RAW264.7细胞的脂质和酯质含量。PPE通过降低tBuOOH在RAW264.7细胞中升高的脂质和酯类脂质化合物的水平发挥细胞保护作用。这些发现表明PPE具有抑制内源性活性氧的能力，具有细胞保护潜能。结论：本研究扩展了对PPE植物化学及其抗氧化和细胞保护作用的现有认识。这些发现支持使用SR-FTIR显微光谱来确定天然产物的细胞保护作用。PPE提取物可能是针对预防氧化应激相关疾病的新疗法和营养保健品的候选化合物。请在本文中注明：Dunkhunthod B， Thumanu K, Teethaisong Y, Sittisart P, Sittisart P。黑客。基于同步辐射的傅里叶变换红外微光谱法评价乙醇提取物。集成医学[J]；打印前Epub。
{"title":"Cytoprotective activity of Pogonatherum paniceum (Lam.) Hack. ethanolic extract evaluated by synchrotron radiation-based Fourier transform infrared microspectroscopy","authors":"Benjawan Dunkhunthod , Kanjana Thumanu , Yothin Teethaisong , Priyada Sittisart , Patcharawan Sittisart","doi":"10.1016/j.joim.2025.02.001","DOIUrl":"10.1016/j.joim.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>The present study investigated the cytoprotective effects of a <em>Pogonatherum paniceum</em> extract prepared with 80% ethanol (PPE) using synchrotron radiation-based Fourier transform infrared (SR-FTIR) microspectroscopy and determined its phytochemical profile.</div></div><div><h3>Methods</h3><div>The volatile and polyphenolic compounds in PPE were characterized using gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry, respectively. The antioxidant capacity of PPE was evaluated using chemical and cell-based assays. The SR-FTIR microspectroscopy was performed to evaluate the cytoprotective effect of PPE by identifying changes in macromolecule composition in <em>tert</em>-butyl hydroperoxide (<em>t</em>BuOOH)-induced oxidative damage in RAW264.7 cells.</div></div><div><h3>Results</h3><div>A total of 48 volatile compounds and 28 polyphenol components were found in PPE. PPE exhibited a high potential for antioxidant activity by scavenging the intracellular reactive oxygen species in <em>t</em>BuOOH<em>-</em>induced oxidative damage in RAW264.7 cells. PPE treatment also significantly protected RAW264.7 cells against <em>t</em>BuOOH-induced toxicity and restored cell viability. The SR-FTIR analysis revealed that <em>t</em>BuOOH increased the lipid and ester lipid content in RAW264.7 cells. The PPE exerted a cytoprotective effect by decreasing the levels of lipid and ester lipid compounds that had been elevated by <em>t</em>BuOOH in RAW264.7 cells. These findings indicate that PPE has cytoprotective potential due to its ability to inhibit endogenous reactive oxygen species.</div></div><div><h3>Conclusion</h3><div>This study extends the current knowledge on the phytochemistry of PPE and its antioxidant and cytoprotective effects. These findings support the use of SR-FTIR microspectroscopy to determine the cytoprotective effects of natural products. PPE extract may be a candidate compound for new therapeutics and nutraceuticals that target the prevention of oxidative stress-associated diseases.</div><div><br>Please cite this article as: Dunkhunthod B, Thumanu K, Teethaisong Y, Sittisart P, Sittisart P. Cytoprotective activity of <em>Pogonatherum paniceum</em> (Lam.) Hack. ethanolic extract evaluated by synchrotron radiation-based Fourier transform infrared microspectroscopy. <em>J Integr Med</em>. 2025; 23(2): 182–194.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 182-194"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651512","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}
Treating peripheral nerve injury (PNI) presents a clinical challenge due to limited axon regeneration. Strychni Semen, a traditional Chinese medicine, is clinically used for numbness and hemiplegia. However, its role in promoting functional recovery after PNI and the related mechanisms have not yet been systematically studied.
Methods
A mouse model of sciatic nerve crush (SNC) injury was established and the mice received drug treatment via intragastric gavage, followed by behavioral assessments (adhesive removal test, hot-plate test and Von Frey test). Transcriptomic analyses were performed to examine gene expression in the dorsal root ganglia (DRGs) from the third to the sixth lumbar vertebrae, so as to identify the significantly differentially expressed genes. Immunofluorescence staining was used to assess the expression levels of superior cervical ganglia neural-specific 10 protein (SCG10). The ultra-trace protein detection technique was used to evaluate changes in gene expression levels.
Results
Strychni Semen and its active compounds (brucine and strychnine) improved functional recovery in mice following SNC injury. Transcriptomic data indicated that Strychni Semen and its active compounds initiated transcriptional reprogramming that impacted cellular morphology and extracellular matrix remodeling in DRGs after SNC, suggesting potential roles in promoting axon regeneration. Imaging data further confirmed that Strychni Semen and its active compounds facilitated axon regrowth in SNC-injured mice. By integrating protein–protein interaction predictions, ultra-trace protein detection, and molecular docking analysis, we identified myeloperoxidase as a potentially critical factor in the axon regenerative effects conferred by Strychni Semen and its active compounds.
Conclusion
Strychni Semen and its active compounds enhance sensory function by promoting axonal regeneration after PNI. These findings establish a foundation for the future applications of Strychni Semen and highlight novel therapeutic strategies and drug targets for axon regeneration.
Please cite this article as: Zhang Y, Zhao XY, Liu MT, Zhou ZC, Cheng HB, Jiang XH, Zheng YR, Chen Z. Strychni Semen and its active compounds promote axon regeneration following peripheral nerve injury by suppressing myeloperoxidase in the dorsal root ganglia. J Integr Med. 2025; 23(2): 169–181.
{"title":"Strychni Semen and its active compounds promote axon regeneration following peripheral nerve injury by suppressing myeloperoxidase in the dorsal root ganglia","authors":"Yan Zhang , Xin-yue Zhao , Meng-ting Liu , Zhu-chen Zhou , Hui-bin Cheng , Xu-hong Jiang , Yan-rong Zheng , Zhong Chen","doi":"10.1016/j.joim.2025.03.001","DOIUrl":"10.1016/j.joim.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>Treating peripheral nerve injury (PNI) presents a clinical challenge due to limited axon regeneration. Strychni Semen, a traditional Chinese medicine, is clinically used for numbness and hemiplegia. However, its role in promoting functional recovery after PNI and the related mechanisms have not yet been systematically studied.</div></div><div><h3>Methods</h3><div>A mouse model of sciatic nerve crush (SNC) injury was established and the mice received drug treatment via intragastric gavage, followed by behavioral assessments (adhesive removal test, hot-plate test and Von Frey test). Transcriptomic analyses were performed to examine gene expression in the dorsal root ganglia (DRGs) from the third to the sixth lumbar vertebrae, so as to identify the significantly differentially expressed genes. Immunofluorescence staining was used to assess the expression levels of superior cervical ganglia neural-specific 10 protein (SCG10). The ultra-trace protein detection technique was used to evaluate changes in gene expression levels.</div></div><div><h3>Results</h3><div>Strychni Semen and its active compounds (brucine and strychnine) improved functional recovery in mice following SNC injury. Transcriptomic data indicated that Strychni Semen and its active compounds initiated transcriptional reprogramming that impacted cellular morphology and extracellular matrix remodeling in DRGs after SNC, suggesting potential roles in promoting axon regeneration. Imaging data further confirmed that Strychni Semen and its active compounds facilitated axon regrowth in SNC-injured mice. By integrating protein–protein interaction predictions, ultra-trace protein detection, and molecular docking analysis, we identified myeloperoxidase as a potentially critical factor in the axon regenerative effects conferred by Strychni Semen and its active compounds.</div></div><div><h3>Conclusion</h3><div>Strychni Semen and its active compounds enhance sensory function by promoting axonal regeneration after PNI. These findings establish a foundation for the future applications of Strychni Semen and highlight novel therapeutic strategies and drug targets for axon regeneration.</div><div>Please cite this article as: Zhang Y, Zhao XY, Liu MT, Zhou ZC, Cheng HB, Jiang XH, Zheng YR, Chen Z. Strychni Semen and its active compounds promote axon regeneration following peripheral nerve injury by suppressing myeloperoxidase in the dorsal root ganglia. <em>J Integr Med</em>. 2025; 23(2): 169–181.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 169-181"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606850","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 : 2025-03-01DOI: 10.1016/j.joim.2025.01.005
Anne E Murphy , Anne Arewasikporn , Lisa Taylor-Swanson , David A Williams , Richard E Harris
Objective
Acupuncture has demonstrated efficacy as a treatment for fibromyalgia; however, predictors of short- and long-term analgesic response in this population are not well understood.
Methods
This manuscript describes a secondary analysis of a single-center, blinded, sham-controlled, randomized longitudinal acupuncture clinical trial in fibromyalgia. Baseline characterization included pressure pain threshold and pain interference, while residualized change in pain intensity from baseline to follow-up served as the primary outcome measure. Participants were randomized into groups that received verum (n = 36) or sham (n = 29) acupuncture treatment over a 12-week period (18 treatments) and were followed for 37 weeks from the initiation of treatment.
Results
Lower pressure pain thresholds at baseline were associated with greater analgesia only in the sham treatment group immediately following treatment, while those with higher pressure pain thresholds had greater analgesia with verum treatment (B = –13.43, P = 0.001). Additionally, greater perceived impact of pain at baseline was predictive of greater short-term analgesia irrespective of treatment. Pressure pain threshold was not found to be predictive of long-term differential treatment response (B = –1.71, P = 0.66). There was a significant difference in the relationship between perceived impact of pain at baseline and subsequent long-term analgesia between groups where those with greater perceived impact of pain displayed improved long-term analgesia for verum acupuncture compared to the sham group (B = –11.37, P = 0.004).
Conclusion
Our results support the use of a self-reported pain outcome in predicting long-term analgesia following acupuncture in fibromyalgia.
Please cite this article as: Murphy AE, Arewasikporn A, Taylor-Swanson L, Williams DA, Harris RE. Pressure pain threshold and perceived impact of pain differentially predict short-term and long-term pain reduction following acupuncture in fibromyalgia. J Integr Med. 2025; 23(2): 152–158.
目的：针灸治疗纤维肌痛的疗效已得到证实；然而，这一人群的短期和长期镇痛反应的预测因素尚不清楚。方法：本文对一项单中心、盲法、假对照、随机纵向针灸治疗纤维肌痛的临床试验进行了二次分析。基线特征包括压痛阈值和疼痛干扰，而从基线到随访的疼痛强度的剩余变化是主要的结果测量。参与者被随机分为两组，一组接受verum （n = 36）或sham （n = 29）针灸治疗，为期12周（18次治疗），并从治疗开始进行了37周的随访。结果：基线压痛阈值较低的患者仅在治疗后立即接受假治疗，而压力痛阈值较高的患者在接受verum治疗后镇痛效果较好（B = -13.43, P = 0.001）。此外，无论治疗方式如何，基线疼痛的感知影响更大预示着更大的短期镇痛。压痛阈值不能预测长期治疗差异反应（B = -1.71, P = 0.66）。在基线疼痛感知影响和随后的长期镇痛之间，两组之间的关系有显著差异，与假手术组相比，那些感知到疼痛影响更大的患者在椎体针灸中表现出更好的长期镇痛效果（B = -11.37, P = 0.004）。结论：我们的研究结果支持使用自我报告的疼痛结果来预测针刺后纤维肌痛的长期镇痛。Murphy AE, Arewasikporn A, Taylor-Swanson L, Williams DA, Harris RE.针刺对纤维肌痛症患者短期和长期疼痛缓解的影响。集成医学[J]；打印前Epub。
{"title":"Pressure pain threshold and perceived impact of pain differentially predict short-term and long-term pain reduction following acupuncture in fibromyalgia","authors":"Anne E Murphy , Anne Arewasikporn , Lisa Taylor-Swanson , David A Williams , Richard E Harris","doi":"10.1016/j.joim.2025.01.005","DOIUrl":"10.1016/j.joim.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>Acupuncture has demonstrated efficacy as a treatment for fibromyalgia; however, predictors of short- and long-term analgesic response in this population are not well understood.</div></div><div><h3>Methods</h3><div>This manuscript describes a secondary analysis of a single-center, blinded, sham-controlled, randomized longitudinal acupuncture clinical trial in fibromyalgia. Baseline characterization included pressure pain threshold and pain interference, while residualized change in pain intensity from baseline to follow-up served as the primary outcome measure. Participants were randomized into groups that received verum (<em>n</em> = 36) or sham (<em>n</em> = 29) acupuncture treatment over a 12-week period (18 treatments) and were followed for 37 weeks from the initiation of treatment.</div></div><div><h3>Results</h3><div>Lower pressure pain thresholds at baseline were associated with greater analgesia only in the sham treatment group immediately following treatment, while those with higher pressure pain thresholds had greater analgesia with verum treatment (<em>B =</em> –13.43, <em>P</em> = 0.001). Additionally, greater perceived impact of pain at baseline was predictive of greater short-term analgesia irrespective of treatment. Pressure pain threshold was not found to be predictive of long-term differential treatment response (<em>B =</em> –1.71, <em>P</em> = 0.66). There was a significant difference in the relationship between perceived impact of pain at baseline and subsequent long-term analgesia between groups where those with greater perceived impact of pain displayed improved long-term analgesia for verum acupuncture compared to the sham group (<em>B</em> = –11.37, <em>P</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>Our results support the use of a self-reported pain outcome in predicting long-term analgesia following acupuncture in fibromyalgia.</div><div>Please cite this article as: Murphy AE, Arewasikporn A, Taylor-Swanson L, Williams DA, Harris RE. Pressure pain threshold and perceived impact of pain differentially predict short-term and long-term pain reduction following acupuncture in fibromyalgia. <em>J Integr Med</em>. 2025; 23(2): 152–158.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 152-158"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365084","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 : 2025-03-01DOI: 10.1016/j.joim.2025.01.004
Si-yi Zheng , Xiao-ying Wang , Li-nan Lin , Shan Liu , Xiao-xiao Huang , Yi-yue Liu , Xiao-shuai Yu , Wei Pan , Jian-qiao Fang , Yi Liang
Background
There is a gap in understanding the effects of different acupoints and treatment methods (acupuncture and moxibustion) on microcirculatory changes in the lumbar region.
Objective
This study aimed to assess the thermal effects of acupuncture at Weizhong (BL40), with acupuncture at Chize (LU5) and moxibustion at both acupoints as control interventions.
Design, setting, participants and interventions
In this randomized controlled trial, 140 healthy participants were equally divided into four groups: acupuncture at BL40 (Acu-BL40), acupuncture at LU5 (Acu-LU5), moxibustion at BL40 (Mox-BL40) and moxibustion at LU5 (Mox-LU5). Participants underwent a 30-minute session of their assigned treatment. Infrared thermal imaging was used to collect temperature data on the areas of interest for analysis.
Main outcome measures
The primary measure was the change in average temperature of the observed area after the intervention. The secondary measures included periodic temperature changes every 5 min and the temperature changes of the Governor Vessel and Bladder Meridian in the observed area after the intervention.
Results
Significant interactions were observed between treatments and acupoints affecting temperature (P < 0.001). The Acu-BL40 group showed a notably higher increase in mean temperature after 30 min compared to the Acu-LU5 and Mox-BL40 groups, with increases of 0.29 (95% confidence interval [CI] = 0.17 to 0.41) and 0.24 (95% CI = 0.08 to 0.41) °C, respectively.
Conclusion
Acupuncture at BL40 acupoint can significantly increase the mean temperature in the observed area, highlighting the specific thermal effect of acupuncture compared to moxibustion in the lumbar area. This suggests a potential therapeutic benefit of acupuncture at BL40 for managing lumbar conditions.
Please cite this article as: Zheng SY, Wang XY, Lin LN, Liu S, Huang XX, Liu YY, Yu XS, Pan W, Fang JQ, Liang Y. Lumbar temperature change after acupuncture or moxibustion at Weizhong (BL40) or Chize (LU5) in healthy adults: A randomized controlled trial. J Integr Med. 2025; 23(2): 145–151.
{"title":"Lumbar temperature change after acupuncture or moxibustion at Weizhong (BL40) or Chize (LU5) in healthy adults: A randomized controlled trial","authors":"Si-yi Zheng , Xiao-ying Wang , Li-nan Lin , Shan Liu , Xiao-xiao Huang , Yi-yue Liu , Xiao-shuai Yu , Wei Pan , Jian-qiao Fang , Yi Liang","doi":"10.1016/j.joim.2025.01.004","DOIUrl":"10.1016/j.joim.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>There is a gap in understanding the effects of different acupoints and treatment methods (acupuncture and moxibustion) on microcirculatory changes in the lumbar region.</div></div><div><h3>Objective</h3><div>This study aimed to assess the thermal effects of acupuncture at Weizhong (BL40), with acupuncture at Chize (LU5) and moxibustion at both acupoints as control interventions.</div></div><div><h3>Design, setting, participants and interventions</h3><div>In this randomized controlled trial, 140 healthy participants were equally divided into four groups: acupuncture at BL40 (Acu-BL40), acupuncture at LU5 (Acu-LU5), moxibustion at BL40 (Mox-BL40) and moxibustion at LU5 (Mox-LU5). Participants underwent a 30-minute session of their assigned treatment. Infrared thermal imaging was used to collect temperature data on the areas of interest for analysis.</div></div><div><h3>Main outcome measures</h3><div>The primary measure was the change in average temperature of the observed area after the intervention. The secondary measures included periodic temperature changes every 5 min and the temperature changes of the Governor Vessel and Bladder Meridian in the observed area after the intervention.</div></div><div><h3>Results</h3><div>Significant interactions were observed between treatments and acupoints affecting temperature (<em>P</em> < 0.001). The Acu-BL40 group showed a notably higher increase in mean temperature after 30 min compared to the Acu-LU5 and Mox-BL40 groups, with increases of 0.29 (95% confidence interval [CI] = 0.17 to 0.41) and 0.24 (95% CI = 0.08 to 0.41) °C, respectively.</div></div><div><h3>Conclusion</h3><div>Acupuncture at BL40 acupoint can significantly increase the mean temperature in the observed area, highlighting the specific thermal effect of acupuncture compared to moxibustion in the lumbar area. This suggests a potential therapeutic benefit of acupuncture at BL40 for managing lumbar conditions.</div><div><em>Trial registration</em>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT05665426).</div><div>Please cite this article as: Zheng SY, Wang XY, Lin LN, Liu S, Huang XX, Liu YY, Yu XS, Pan W, Fang JQ, Liang Y. Lumbar temperature change after acupuncture or moxibustion at Weizhong (BL40) or Chize (LU5) in healthy adults: A randomized controlled trial. <em>J Integr Med</em>. 2025; 23(2): 145–151.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 145-151"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042626","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 : 2025-03-01DOI: 10.1016/j.joim.2025.01.003
Cheng Zhang , Yi-sen Nie , Chuan-tao Zhang , Hong-jing Yang , Hao-ran Zhang , Wei Xiao , Guang-fu Cui , Jia Li , Shuang-jing Li , Qing-song Huang , Shi-yan Yan
Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with “stopping” and “continuation” criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation.
Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. J Integr Med. 2025; 23(2): 138–145.
进行性肺纤维化（PPF）是一种进展性致命疾病，几乎没有有效的治疗方案。即使接受已获批准的抗纤维化药物治疗，PPF 患者的生活质量改善仍然有限。传统中医药有可能改善 PPF 患者的咳嗽、呼吸困难和疲劳症状。中医治疗通常是多样化和个性化的，因此迫切需要开发高效、精确的设计策略，以确定有效的治疗方案。我们设计了一项创新的贝叶斯自适应两阶段试验，希望为快速评估中医药对 PPF 的疗效提供新思路。我们将在中国开展一项开放标签、两阶段、自适应贝叶斯随机对照试验。根据贝叶斯方法，试验将采用反应自适应随机化，根据试验过程中收集的数据将患者分配到研究组。自适应贝叶斯试验设计将采用贝叶斯分层模型，一旦达到预先确定的优效或无效的后验概率和决策阈值，将采用 "停止 "和 "继续 "标准。通过共享我们已实施的子试验的主方案和组织管理机制，可以更高效地实施试验。患者报告的主要结果是莱斯特咳嗽问卷评分的变化，这反映了咳嗽特异性生活质量的改善。自适应贝叶斯试验设计可能是促进快速临床评估中医药治疗PPF疗效的一种有前途的方法，并将为如何评估中医药治疗罕见和难治性疾病的疗效提供一个范例。然而，由于试验实施的复杂性，需要专业统计分析人员进行充分的模拟分析，构建贝叶斯反应自适应随机化程序，以便及时做出反应。此外，还需要制定详细的标准操作程序，以确保试验实施的可行性。本文引用如前：Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY.中药治疗进行性肺纤维化的自适应贝叶斯随机对照试验：原理与研究设计。J Integr Med.2025; Epub ahead of print.
{"title":"An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design","authors":"Cheng Zhang , Yi-sen Nie , Chuan-tao Zhang , Hong-jing Yang , Hao-ran Zhang , Wei Xiao , Guang-fu Cui , Jia Li , Shuang-jing Li , Qing-song Huang , Shi-yan Yan","doi":"10.1016/j.joim.2025.01.003","DOIUrl":"10.1016/j.joim.2025.01.003","url":null,"abstract":"<div><div>Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with “stopping” and “continuation” criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation.</div><div>Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. <em>J Integr Med</em>. 2025; 23(2): 138–145.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 138-144"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042625","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 : 2025-03-01DOI: 10.1016/j.joim.2025.02.004
Renming Liu , Aung Aung Kywe Moe , Weiting Liu , Maryam Zoghi , Shapour Jaberzadeh
Background
Acupuncture is widely used in modulating brain excitability and motor function, as a form of complementary and alternative medicine. However, there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability (CSE), and the credibility of the evidence has yet to be quantified.
Objective
This study was designed to assess the efficacy and safety of electroacupuncture (EA) and manual acupuncture (MA) in enhancing brain excitability, specifically focusing on CSE as measured by transcranial magnetic stimulation (TMS).
Search strategy
This study followed a systematic approach, searching 9 databases up to August 2024 and examining grey literature, in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Inclusion criteria
Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture, no treatment or usual training.
Data extraction and analysis
Three investigators independently conducted literature screening, data extraction, and risk of bias assessment. The primary outcome focused on motor-evoked potentials as measured by TMS, with treatment effects quantified using mean differences or standardized mean differences between pre- and post-treatment. Subgroup analyses were conducted using mixed-effects models, while random-effects or fixed-effects models were used to estimate average treatment differences across studies.
Results
Based on 34 studies involving 1031 adults, acupuncture techniques significantly enhanced CSE. EA had a greater impact than MA, with effect sizes of 0.53 mV vs 0.43 mV (95% confidence interval [CI]: [0.30, 0.76], P < 0.00001 vs 95% CI: [0.28, 0.59], P < 0.00001). The 5 most frequently used acupoints were LI4 (Hegu, 32 times), ST36 (Zusanli, 10 times), LI11 (Quchi, 7 times), TE5 (Waiguan, 6 times), and GB34 (Yanglingquan, 5 times).
Conclusion
This systematic review indicates that both EA and MA could effectively and safely enhance CSE, bringing the corticospinal pathway closer to the threshold for firing, which may ultimately improve motor function. LI4, ST36, LI11, TE5 and GB34 are the most commonly used acupoints.
Please cite this article as: Liu R, Moe AAK, Liu W, Zoghi M, Jaberzadeh S. Does acupuncture at motor-related acupoints affect corticospinal excitability? A systematic review and meta-analysis. J Integr Med. 2025; 23(2): 113–125.
背景：针灸作为一种补充和替代医学，在调节大脑兴奋性和运动功能方面被广泛应用。然而，目前还没有meta分析评估针刺对皮质脊髓兴奋性（CSE）的有效性和安全性，证据的可信度也有待量化。目的：本研究旨在评估电针（EA）和手针（MA）增强脑兴奋性的有效性和安全性，特别关注经颅磁刺激（TMS）测量的CSE。检索策略：本研究采用系统方法，检索了截至2024年8月的9个数据库，并检查了灰色文献，符合系统评价和荟萃分析指南的首选报告项目。纳入标准：如果将EA或MA与假针灸、不治疗或常规训练的临床疗效进行比较，则纳入研究。资料提取和分析：三位研究者独立进行文献筛选、资料提取和偏倚风险评估。主要结果集中在经颅磁刺激测量的运动诱发电位，治疗效果使用治疗前后的平均差异或标准化平均差异来量化。使用混合效应模型进行亚组分析，而使用随机效应或固定效应模型来估计研究之间的平均治疗差异。结果：基于34项涉及1031名成人的研究，针灸技术可显著提高CSE。EA的影响大于MA，效应值为0.53 mV vs 0.43 mV（95%可信区间[CI]: [0.30, 0.76]， P）。结论：本系统评价提示EA和MA均能有效、安全地增强CSE，使皮质脊髓通路更接近放电阈值，最终可能改善运动功能。LI4、ST36、LI11、TE5、GB34是最常用的穴位。刘r， Moe AAK，刘伟，Zoghi M, Jaberzadeh S.针刺运动相关穴位是否影响皮质脊髓兴奋性？系统回顾和荟萃分析。集成医学[J]；打印前Epub。
{"title":"Does acupuncture at motor-related acupoints affect corticospinal excitability? A systematic review and meta-analysis","authors":"Renming Liu , Aung Aung Kywe Moe , Weiting Liu , Maryam Zoghi , Shapour Jaberzadeh","doi":"10.1016/j.joim.2025.02.004","DOIUrl":"10.1016/j.joim.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Acupuncture is widely used in modulating brain excitability and motor function, as a form of complementary and alternative medicine. However, there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability (CSE), and the credibility of the evidence has yet to be quantified.</div></div><div><h3>Objective</h3><div>This study was designed to assess the efficacy and safety of electroacupuncture (EA) and manual acupuncture (MA) in enhancing brain excitability, specifically focusing on CSE as measured by transcranial magnetic stimulation (TMS).</div></div><div><h3>Search strategy</h3><div>This study followed a systematic approach, searching 9 databases up to August 2024 and examining grey literature, in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</div></div><div><h3>Inclusion criteria</h3><div>Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture, no treatment or usual training.</div></div><div><h3>Data extraction and analysis</h3><div>Three investigators independently conducted literature screening, data extraction, and risk of bias assessment. The primary outcome focused on motor-evoked potentials as measured by TMS, with treatment effects quantified using mean differences or standardized mean differences between pre- and post-treatment. Subgroup analyses were conducted using mixed-effects models, while random-effects or fixed-effects models were used to estimate average treatment differences across studies.</div></div><div><h3>Results</h3><div>Based on 34 studies involving 1031 adults, acupuncture techniques significantly enhanced CSE. EA had a greater impact than MA, with effect sizes of 0.53 mV <em>vs</em> 0.43 mV (95% confidence interval [CI]: [0.30, 0.76], <em>P</em> < 0.00001 <em>vs</em> 95% CI: [0.28, 0.59], <em>P</em> < 0.00001). The 5 most frequently used acupoints were LI4 (Hegu, 32 times), ST36 (Zusanli, 10 times), LI11 (Quchi, 7 times), TE5 (Waiguan, 6 times), and GB34 (Yanglingquan, 5 times).</div></div><div><h3>Conclusion</h3><div>This systematic review indicates that both EA and MA could effectively and safely enhance CSE, bringing the corticospinal pathway closer to the threshold for firing, which may ultimately improve motor function. LI4, ST36, LI11, TE5 and GB34 are the most commonly used acupoints.</div><div><br>Please cite this article as: Liu R, Moe AAK, Liu W, Zoghi M, Jaberzadeh S. Does acupuncture at motor-related acupoints affect corticospinal excitability? A systematic review and meta-analysis. <em>J Integr Med</em>. 2025; 23(2): 113–125.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 113-125"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651469","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 : 2025-03-01DOI: 10.1016/j.joim.2025.01.001
Miranda Sin-Man Tsang , Iris Wenyu Zhou , Anthony Lin Zhang , Charlie Changli Xue
Background
Over 65 million people have long COVID. Evidence for using Chinese herbal medicine (CHM) to treat long COVID is growing. A systematic review of evidence for guiding clinical decision is warranted.
Objective
To examine the effects and safety of CHM in alleviating the severity of dyspnea, fatigue, exercise intolerance, depression, anxiety and insomnia in long COVID adults based on registered randomized clinical trials (RCT).
Search strategy
World Health Organization International Clinical Trials Registry Platform and Chinese Clinical Trial Registry were searched for registered trial protocols from database inception to February 10, 2023. English (PubMed, Embase, AMED and CINAHL) and Chinese databases (CNKI, Wanfang Data and CQVIP) were then searched to identify relevant publications from December 2019 through April 6, 2023.
Inclusion criteria
Registered RCTs that compared the effects of Chinese herbal medicines or Chinese herbal formulas against a control treatment (i.e., the placebo or usual care) in adults with persistent symptoms of long COVID. The primary outcome of dyspnea, and secondary outcomes of fatigue, exercise intolerance, depression, anxiety and insomnia were measured using validated tools at the end of the treatment.
Data extraction and analysis
Data were extracted, and eligible RCTs were evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials and Grading of Recommendations, Assessment, Development and Evaluations independently by two researchers. Effect sizes were estimated by random-effects modelling and mean difference (MD). Heterogeneity between trials was quantified by I2.
Results
Among the 38 registered clinical trials we identified, seven RCTs (1,519 patients) were included in the systematic review. One RCT had a low overall risk of bias. Compared to the control, CHM reduces dyspnea on the Borg Dyspnea Scale score (MD = –0.2, 95% confidence interval [CI] = –0.65 to 0.25) with moderate certainty, and reduces fatigue on the Borg Scale (MD = –0.48, 95% CI = –0.74 to –0.22) with low certainty. CHM clinically reduces depression on Hamilton Depression Rating Scale score (MD = –6.00, 95% CI = –7.56 to –4.44) and anxiety on Hamilton Anxiety Rating Scale score (MD = –6.10, 95% CI = –7.67 to –4.53), and reduces insomnia on the Insomnia Severity Index (MD = –4.86, 95% CI = –12.50 to 2.79) with moderate certainty. Meta-analysis of two RCTs (517 patients) showed that CHM clinically improves exercise intolerance by increasing 6-minute walking distance (MD = –15.92, 95% CI = –10.20 to 42.05) with substantial heterogeneity (I2 = 68%) and low certainty.
Conclusion
CHM is associated with a post-treatment clinical reduction in depression and anxiety in long COVID adults, compared to
背景：超过6500万人长期感染COVID。使用中草药治疗新冠肺炎的证据越来越多。有必要对指导临床决策的证据进行系统的审查。目的：通过注册随机临床试验（RCT），探讨中药缓解长冠成人呼吸困难、疲劳、运动不耐受、抑郁、焦虑和失眠严重程度的效果和安全性。检索策略：检索世界卫生组织国际临床试验注册平台和中国临床试验注册中心从数据库建立到2023年2月10日的注册试验方案。然后检索英文（PubMed, Embase， AMED和CINAHL）和中文数据库（CNKI，万方数据和CQVIP），以确定2019年12月至2023年4月6日的相关出版物。纳入标准：注册的随机对照试验，比较中草药或中草药配方与对照治疗（即安慰剂或常规护理）对长期出现COVID持续症状的成年人的影响。在治疗结束时，使用经过验证的工具测量呼吸困难的主要结局和疲劳、运动不耐受、抑郁、焦虑和失眠的次要结局。数据提取和分析：提取数据，使用Cochrane随机试验风险偏倚工具2版对符合条件的随机对照试验进行评估，并由两名研究人员独立对推荐、评估、发展和评价进行分级。效应大小通过随机效应模型和平均差（MD）估计。试验间异质性用I2量化。结果：在我们纳入的38项注册临床试验中，7项随机对照试验（1519例患者）被纳入系统评价。一项RCT总体偏倚风险较低。与对照组相比，CHM减轻Borg呼吸困难量表评分（MD = -0.2, 95%可信区间[CI] = -0.65至0.25），中度确定性减轻Borg呼吸困难量表评分（MD = -0.48, 95% CI = -0.74至-0.22），低确定性减轻Borg呼吸困难量表疲劳（MD = -0.48, 95% CI = -0.74至-0.22）。CHM临床减轻汉密尔顿抑郁评定量表抑郁评分（MD = -6.00, 95% CI = -7.56 ~ -4.44）和汉密尔顿焦虑评定量表焦虑评分（MD = -6.10, 95% CI = -7.67 ~ -4.53），减轻失眠严重程度指数（MD = -4.86, 95% CI = -12.50 ~ 2.79），具有中等确定性。两项随机对照试验（517例患者）的荟萃分析显示，CHM通过增加6分钟步行距离在临床上改善了运动不耐受（MD = -15.92, 95% CI = -10.20 ~ 42.05），存在很大的异质性（I2 = 68%），且确定性较低。结论：与对照组相比，CHM与治疗后抑郁和焦虑的临床减少有关，但对呼吸困难和失眠的治疗效果不强。中草药对运动不耐受和疲劳的影响尚不确定，使用中草药的安全性仍然值得怀疑。曾美娟，周爱文，张爱玲，薛春春。中药治疗长冠肺炎呼吸困难和持续性症状：随机对照试验的系统评价和meta分析。集成医学[J]；打印前Epub。
{"title":"Chinese herbal medicine for dyspnea and persistent symptoms of long COVID: A systematic review and meta-analysis of randomized controlled trials","authors":"Miranda Sin-Man Tsang , Iris Wenyu Zhou , Anthony Lin Zhang , Charlie Changli Xue","doi":"10.1016/j.joim.2025.01.001","DOIUrl":"10.1016/j.joim.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Over 65 million people have long COVID. Evidence for using Chinese herbal medicine (CHM) to treat long COVID is growing. A systematic review of evidence for guiding clinical decision is warranted.</div></div><div><h3>Objective</h3><div>To examine the effects and safety of CHM in alleviating the severity of dyspnea, fatigue, exercise intolerance, depression, anxiety and insomnia in long COVID adults based on registered randomized clinical trials (RCT).</div></div><div><h3>Search strategy</h3><div>World Health Organization International Clinical Trials Registry Platform and Chinese Clinical Trial Registry were searched for registered trial protocols from database inception to February 10, 2023. English (PubMed, Embase, AMED and CINAHL) and Chinese databases (CNKI, Wanfang Data and CQVIP) were then searched to identify relevant publications from December 2019 through April 6, 2023.</div></div><div><h3>Inclusion criteria</h3><div>Registered RCTs that compared the effects of Chinese herbal medicines or Chinese herbal formulas against a control treatment (i.e., the placebo or usual care) in adults with persistent symptoms of long COVID. The primary outcome of dyspnea, and secondary outcomes of fatigue, exercise intolerance, depression, anxiety and insomnia were measured using validated tools at the end of the treatment.</div></div><div><h3>Data extraction and analysis</h3><div>Data were extracted, and eligible RCTs were evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials and Grading of Recommendations, Assessment, Development and Evaluations independently by two researchers. Effect sizes were estimated by random-effects modelling and mean difference (MD). Heterogeneity between trials was quantified by <em>I<sup>2</sup></em>.</div></div><div><h3>Results</h3><div>Among the 38 registered clinical trials we identified, seven RCTs (1,519 patients) were included in the systematic review. One RCT had a low overall risk of bias. Compared to the control, CHM reduces dyspnea on the Borg Dyspnea Scale score (MD = –0.2, 95% confidence interval [CI] = –0.65 to 0.25) with moderate certainty, and reduces fatigue on the Borg Scale (MD = –0.48, 95% CI = –0.74 to –0.22) with low certainty. CHM clinically reduces depression on Hamilton Depression Rating Scale score (MD = –6.00, 95% CI = –7.56 to –4.44) and anxiety on Hamilton Anxiety Rating Scale score (MD = –6.10, 95% CI = –7.67 to –4.53), and reduces insomnia on the Insomnia Severity Index (MD = –4.86, 95% CI = –12.50 to 2.79) with moderate certainty. Meta-analysis of two RCTs (517 patients) showed that CHM clinically improves exercise intolerance by increasing 6-minute walking distance (MD = –15.92, 95% CI = –10.20 to 42.05) with substantial heterogeneity (<em>I<sup>2</sup></em> = 68%) and low certainty.</div></div><div><h3>Conclusion</h3><div>CHM is associated with a post-treatment clinical reduction in depression and anxiety in long COVID adults, compared to","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 126-137"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460060","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 : 2025-03-01DOI: 10.1016/j.joim.2025.01.002
Saurabh Pandey , Avinash C. Pandey , Vaidya Rajesh Kotecha
Yoga is a therapeutic practice renowned for its multifaceted benefits across the body’s systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body’s various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga’s effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers.
Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga—A complementary and traditional medicine for human health. J Integr Med. 2025; 23(2): 93–105.
{"title":"Yoga—A complementary and traditional medicine for human health","authors":"Saurabh Pandey , Avinash C. Pandey , Vaidya Rajesh Kotecha","doi":"10.1016/j.joim.2025.01.002","DOIUrl":"10.1016/j.joim.2025.01.002","url":null,"abstract":"<div><div>Yoga is a therapeutic practice renowned for its multifaceted benefits across the body’s systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body’s various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga’s effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers.</div><div><br>Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga—A complementary and traditional medicine for human health. <em>J Integr Med</em>. 2025; 23(2): 93–105.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 2","pages":"Pages 93-105"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041439","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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