Forschende Komplementarmedizin最新文献

Background: Some studies have shown beneficial effects of needle acupuncture on physical performance.

Objective: To evaluate immediate effects of a standardized acupuncture treatment on vertical jumping performance.

Subjects and methods: 12 healthy sport students participated in the study. A randomized crossover design was used to investigate specific effects of real acupuncture, sham acupuncture and a no-acupuncture waiting list condition on myoelectric activity and kinematic parameters (duration of ground contact, maximum jumping height) in one-legged drop jumps.

Results: The results of the present study do not demonstrate significant treatment effects on myoelectric and kinematic parameters. However, real acupuncture tends to result in a relative decrease in the duration of ground contact accompanied by increased muscular innervation.

Conclusion: Acupuncture treatment had no significant impact on muscular performance of lower leg in stretch-shortening cycle under the present conditions. As to further research, the potential efficacy of acupuncture for improving reactive strength should be investigated in terms of controlled trials with stratified randomization according to physical performance capacity.

Background: Recent years have seen an explosion of scientific papers that deal with drugs from the fruits of milk thistle and its active substances silymarin (standardized mixture of flavonolignanes), thus justifying an updated systematic review.

Methods: Electronic databases identified silymarin, silibinin, silicristin or milk thistle as descriptors in >700 papers (34% published in last 5 years; 92% dealt with animal pharmacological). Only papers adequately reporting on experimental conditions, dosing, variables tested and statistics were analysed.

Results: Silymarin was found to modify specifically the functions related to various transporters and receptors located in the cell membranes; that is, organic anion uptake transporter peptides (OATP), ABC transporters (P-gp), bile salt export pump, as well as TNF-alpha-dependent and possibly selectin-dependent phenomena. In the cytoplasm, some antioxidant properties and the inhibition of the lipoxygenase pathway seem quite selective and could concur to the antitoxic effects. Some effects like the inhibition of inducible nitric-oxide synthase, of nuclear factor kappa B, and reduction of collagen synthesis are indicative of DNA/RNA-mediated effects. Several studies using 'in vitro' and 'in vivo' cancer models suggest a potential of silymarin in such diseases. Topical and systemic silymarin has skin protective properties against UV-induced damage in epidermis and causes an up-regulation of tumour-suppressor genes p53- and p21CIP1. There were no data on hepatic viral replication, viremia or spontaneous tumours in the data examined.

Conclusions: Data presented here do not solve the question about the complex mechanism(s) of action of the medicinal herbal drug silymarin. Silymarin may be a natural multi-functional and multi-target drug.

A randomized experiment was set up in which 7,500 policyholders of Switzerland's largest health insurance fund, Helvetia, were offered free supplementary insurance for complementary medicine for 3 years. This was meant to simulate a situation in which the experimental group had access to the full range of complementary medical treatments under their health insurance policies. The remaining policyholders in the scheme (670,000 people) formed the control group. A third group of policyholders who had taken out additional insurance for complementary medical services at their own expense is mentioned only in passing. The health insurer's cost and benefit data were analyzed to evaluate the effect of the offered free supplementary insurance for complementary medicine. In addition, a survey was carried out among random samples of subjects from the experimental group and from the control group using the 36-Item Short-Form Health Survey (SF-36) to examine the effects of including complementary medicine on people's subjective state of health. The analysis of the cost data showed that subjects in the experimental group used complementary medicine in addition to mainstream medical services. It became also clear that alternative medical treatments were given in combination with orthodox medicine; less than 1% of the experimental group used exclusively alternative medical services. However, as only a very small percentage of the experimental subjects (6.6%) took advantage of complementary medicine, no significant impact on overall health cost could be inferred. On the other hand, multiple regressions showed that the use of complementary medicine had a greater effect on the treatment costs than sex, age or language region. Neither at the beginning nor the end of the experiment were any significant differences noted in the scales of the SF-36 between the experimental and the control group; nor did multiple regressions reveal any effects on subjects' state of health due to the inclusion of complementary medicine in the basic insurance cover. This study was presented in the media and at a public hearing of the Swiss National Science Foundation. It triggered numerous valuable discussions. The study design and the conclusions were not left uncontested.

As an addition to the project on 'Complementary Medicine and Health Law' carried out within the NFP34 it became highly desirable to compare the Swiss legal situation with that of most European countries. Therefore, the project compiled and analyzed the legal status of 23 European countries concerning the licensing regulations for providers of complementary medical services and the corresponding reimbursement policies. There are considerable differences between the various countries in legal and in practical terms; for the time being a confusing situation in view of a possible European harmonization. This project is a first step in the direction of a European overview on legal preconditions for the provision of and the reimbursement for services in complementary medicine.

40 patients with primary difficulties in either falling asleep or remaining asleep were diagnosed according to the traditional Chinese medicine, allocated to specific diagnostic subgroups and treated individually by a practitioner in his private practice. The patients were randomized into two groups, one receiving true acupuncture, the other needled at non-acupuncture points for 3-5 sessions at weekly intervals. The outcome of the therapy was assessed in several ways, first and foremost by an objective measurement of the sleep quality by polysomnography in a specialized sleep laboratory, performed once before and once after termination of the series of treatments. Additional qualitative results were obtained from several questionnaires. The objective measurement showed a statistically significant effect only in the patients who received the true acupuncture. The subjective, qualitative assessment was better in the proper treatment group than in the control group but was not calculated statistically for methodological reasons. Based on the results of this study, it can be concluded that true and individualized acupuncture indeed shows efficacy in primary sleep disorders. However, a direct influence by the therapist cannot be excluded.

This study served to compare the effect of needling at true acupuncture points with that of needling at non-acupuncture points. Various parameters were used to quantify the results such as measurement of the peripheral blood circulation in finger tips and the nasal mucous membrane, measurement of the skin temperature at various sites of the body by means of infrared thermography or contact thermometry, testing of skin conductance, or recording of heart frequency and respiration. These are all indicators of the functional state of the autonomic nervous system. This model experiment was performed on healthy volunteers and showed identical, transient, quick reflex responses of the sympathetic nervous system after true acupuncture as well as after needling at non-acupuncture points. These reactions are related to pain and do not allow to draw any conclusions on the specificity of the points that were needled. The aim of this project was not to make a statement about the therapeutic efficacy of acupuncture. It was meant to be a model allowing the study of some basic regulatory mechanisms which are fundamental for most treatments in complementary medicine.

The reasons for choosing between various therapeutic possibilities depend in part on rational and in part on emotional factors. This project dealt with the systematic verification of some decision factors most of which were known already. The project was divided in a qualitative and a quantitative part. The qualitative segment was based on semistructured interviews with patients of general practitioners or of naturopaths. This procedure is often used in ethnological research. It identified and evaluated the main motives for the individual choices of therapies by the patients. The quantitative part of the study was carried out by a procedure often used in social sciences, namely by strictly structured telephone interviews of several thousand policyholders of the health insurance fund Helvetia. The aim of this part of the study was to verify the findings of the qualitative study and to investigate the possible significance of additional sociological factors for the choice between different therapies. The conclusions drawn from the abundance of data show that a widespread use of complementary medicine is a reality. Both parts of the project came to the same conclusions. The patients use complementary medicine in a very pragmatic way, be it alternately, be it in parallel but not necessarily in addition to mainstream medicine. The behavior of the patients is very complex, depends on many factors, and can neither be predicted nor easily influenced, not even by an additional free insurance for complementary medicine which was offered to one of the subgroups of the study (in conjunction with J. Sommer's project 'A Randomized Experiment Studying the Effect of Including Complementary Medicine in the Mandatory Benefit Package of Health Insurance Funds in Switzerland'). The interpretation of the telephone interviews concerning the significance of some of the registered sociological factors turned out to be difficult. The project aimed primarily at illustrating the use of complementary medicine and at characterizing its users.

This study investigated 120 pregnant women cared for and treated by physicians specialized in homeopathy and 85 pregnant women cared for and treated by mainstream gynecologists. Quality of life was assessed twice during pregnancy and once shortly after delivery by the instrument SEIQoL (Schedule for the Evaluation of Individualized Quality of Life). In addition, the study registered individual personality characteristics, the psychological situation, the attitude towards the forthcoming delivery, and the functional state before and after delivery. It turned out that women who preferred homeopathic care judged their quality of life lower than women from the other group. However, their criteria for medical decisions and for the assessment of their own personal situation differed as well. There was some correlation between quality of life and age, number of deliveries, partnership and certain personality characteristics. The study showed the importance of paying more attention to the subjective world of the pregnant women. This applies especially in an analysis of two dissimilar therapeutic systems. It could also be concluded that the SEIQoL was a useful instrument for such a study. Finally it turned out that the two populations investigated were different.