Advances in integrative medicine最新文献

Rheumatoid arthritis (RA) is a chronic debilitating disease most commonly seen in middle-aged women and that has unique challenge in its management. A 30 year old woman diagnosed with RA for 4 years presented with severe morning stiffness, pain, occasional numbness and tingling in her hands, wrists, as well as elbows with gait aberration. She also presented with ulnar deviation and swan neck deformity and reported an inability to perform her daily chores. She was not on any medication when she was admitted in an alternative health care setting where she was intervened with a specified protocol of yoga & naturopathy based lifestyle intervention (YNBL) which included yoga therapy, hydrotherapy, manipulative therapies, physiotherapy, western acupuncture, therapeutic fasting and dietary modifications for 3 months. The patient was followed-up for a period of 3 months from discharge. The data reveals significant improvement in the RA related Quality of Life scores (28−4), Visual analog score for pain (8−2), weight (30–35 kg), hemoglobin (9–9.8 gm/dl), erythrocyte sedimentation rate (80–28 mm/hr), RA factor (81.5–65 IU/mL), Anti- Citrullinated Protein Antibody (410–198 EU/mL). YNBL protocol was well tolerated by the patient and has shown significant reduction in inflammation, improvement in quality of life as well reversal of structural deformity. The results are encouraging to conduct large scale randomized control trials to explore the possibility of utilizing YNBL in the management of RA.

Background and purpose

Gastroesophageal reflux disease (GERD) has an adverse impact on the quality of life of affected individuals. Diaphragmatic breathing training (DBT) my be effective in GERD, but research on the benefits of this complementary therapy for affected patients is scarce. This study was therefore intended to examine the effects of DBT on the quality of life and clinical symptoms of patients with GERD.

Materials and methods

This is a randomized controlled trial with two-parallel groups. The experimental group (n = 47) received four weeks of DBT sessions plus treatment-as-usual, while the control group (n = 49) maintained treatment-as-usual only. The outcome variables were measured using the Reflux Disease Questionnaire and GERD-Quality of Life questionnaire. The questionnaires were completed before and after the intervention.

Results

The mean scores of symptom frequency (p < 0.001), symptom severity (p < 0.001) and quality of life (p = 0.001) decreased significantly after the intervention in the two groups. The results also showed that the difference between before and after intervention for mean scores of symptom frequency (p = 0.006), symptom severity (p = 0.001) and quality of life (p = 0.004) was significant in the experimental group compared to the control group. Furthermore, no statistically significant difference in patients' satisfaction with their condition was found between the two groups before (p = 0.698) and after (p = 0.124) the intervention.

Conclusion

Diaphragmatic breathing training can alleviate symptoms and improve quality of life in patients with GERD.

Background

The aim was to explore experiences of individuals with the controversial conditions bile acid diarrhoea (BAD) and bile acid malabsorption (BAM). BAD/BAM are poorly understood, misdiagnosis is common and there is evidence that around a third of patients with Irritable Bowel Syndrome (diarrhoea) (IBS-D) may have BAD/BAM.

Methods

In depth, semi-structured interviews were undertaken with six participants, all female, 18 + years old and living in the UK. All had been diagnosed with BAD/BAM for at least one year. Interviews were recorded and transcribed verbatim. Data was coded and thematic analysis was undertaken using grounded theory.

Results

Six main themes emerged including 1. triggers, and how to control symptoms; 2. experience of diagnosis/care and associated delays; 3. psychosocial impact of the condition, this specifically identified impacts on mental health; 4. the signs and symptoms; 5. comorbidities and other health problems and finally 6. self-education/learning for management of BAD/BAM. Findings indicate that BAD and BAM are often poorly understood; and patients experience delays with diagnosis and moreover that the condition has profound effects on the lives of patients including impacting on mental health. A low-fat diet was identified as useful in managing symptoms, however participants had concerns over absorption of fat-soluble vitamins such as vitamin D and often experienced fatigue.

Conclusion

Further research is recommended to understand both the psychosocial and nutritional impacts of BAD/BAM and to understand the management strategies of patients and the potential role of integrative medicine in caring for this group.

Objectives

New Zealand has experienced an increase in the use of traditional and complementary medicine treatment modalities, such as that of naturopathy. Limited research exists that has examined older aged New Zealanders utilisation of naturopathic treatment modalities. Therefore, the primary aim of this study was to provide a demographic profile of older adults who attended a student naturopathic clinic over a 2-year period. A secondary aim was to identity the symptoms or conditions for which treatment was sought.

Methods

De-identified data were collected for 76 older-aged (>65 years) clients, 28 male and 48 female clients aged between 65 and 88 years of age (71 ± 5.8).

Results

The majority of older aged clients who attended the clinic, were female, in the young-old age group (65–74 years of age) and identified as being New Zealand European. Treatment was predominately sought for chronic health conditions, such as constipation, chronic pain, and arthritis.

Conclusions

The older aged clients in our study were predominately seeking naturopathic treatment for the management of their chronic health conditions.

Background

Quality of sleep is usually compromised in the geriatric population resulting in excessive daytime sleepiness, difficulty sustaining attention, slowed response time, difficulty with memory, and decreased performance. Acupuncture has been established as an alternative therapy, but methodological research still needs to verify its efficacy in sleep disturbances. Hence, a pilot placebo-controlled trial was designed to assess 3 acupuncture point's effect on sleep quality in the geriatric population staying in a nursing home.

Methods

A total of 40 elderly subjects with self-reported sleep disturbance (age with mean± SD = 69.55 ± 7.80) were recruited and allocated to two groups comprising an experimental (n = 20) and a control group (n = 20). Participants were randomly allocated with an allocation ratio of 1:1. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) scores were obtained at baseline and following two weeks. Subjects in the experimental group received needling of Shenmen (HT-7), Baihui (GV-20) and Yintang (EX-HN-3) acupoints for 30 min per day for two weeks, and the control group received placebo points during the respective interventions.

Results

After two weeks of acupuncture, the intervention result showed a significant reduction in all components of PSQI and global PSQI scores (p < 0.001) and a significant increase in ESS score (p < 0.001) in the experimental group compared to the control group.

Conclusion

The study reveals that two weeks of acupuncture intervention significantly positively affect sleep quality in older adults.

Autoimmune hepatitis (AIH) is a chronic and progressive inflammatory process of the liver, with standard treatments including prednisone, azathioprine, and ultimately liver transplant. While there are many integrative and Ayurvedic treatment options that have been shown to be helpful for other liver diseases, there are no studies that have been performed to evaluate these therapies particularly in AIH with cirrhosis. We detail the case of a 55-year-old female with cirrhosis in the setting of AIH placed on a liver transplant list after being treated with conventional therapies. She was started on various nutritional supplements and Ayurvedic treatments which resulted in a significant decrease in her Model for End-Stage Liver Disease score, which was sustained at 7 months. This is the first case report to our knowledge detailing an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function. This paper outlines a novel approach to Autoimmune hepatitis with cirrhosis that utilizes a collaboration between Conventional, Integrative and Ayurvedic practitioners. While the basic science supports the efficacy of the individual treatments utilized in this case, there have been no published case reports outlining the safety and efficacy of these treatments when combined in a clinical setting of cirrhosis due to Autoimmune hepatitis. Thus, we set out to detail the first such case report to our knowledge of an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function.

Background and objectives

Chronic Venous Insufficiency (CVI) is often associated with prolonged standing at work. CVI could lead to multiple symptoms and vascular inflammation. Yoga as therapy has helped in mitigating several occupational hazards. The current study protocol is designed to assess the effect of Yoga on CVI.

Materials and methods

One hundred industry workers with CVI will be randomly allotted to Yoga and wait-list control groups following an equal allocation ratio. Yoga group will receive a specially designed Yoga module six days a week for three months. The Control group will continue with the routine activities. Serum homocysteine, Venous Clinical Severity Scale (VCSS), Ankle Brachial pressure index and psychological status will be assessed at baseline and the end of three months of intervention.

Statistical analyses

Data will be tested for normality and appropriate tests will be used to assess the differences between the groups.

Expected outcomes

Specifically designed Yoga module will help to reduce the vascular inflammation, symptoms of CVI and enhance psychological functioning.

Persian medicine is a branch of complementary and alternative medicine that tries to offer simple and suitable approaches and methods for treating diseases and health protection. Ma'oljobon is known as a kind of whey protein. It is a remedy with various characteristics, such as removing viscous wastes from the body without causing any dryness and moistening, while also providing nutrition. A 7-year-old boy with severe chronic cough refers to Traditional Persian Medicine Clinic due to allergic rhinitis. Formerly he had multiple failed attempts of treatment. The cough resolved with a 12-week period administration of Ma'oljobon. This is the first report evaluating the remedial effect of Ma'oljobon on allergic rhinitis.