Alternative therapies in health and medicine最新文献

Background: Large language models have demonstrated remarkable promise in medical data analysis, but serious concerns about reliability and error propagation persist. This study reports a novel approach of using iterative consultation between two independent AI systems to analyze complex clinical neuroimaging data.

Methods: A 63-year-old woman with a family history of Alzheimer's disease and Parkinsonism underwent brain MRI volumetry showing apparent 10-13% increases in gray matter volume following intensive multimodal interventions (Functional Medicine and HYLANE™ treatment). Despite clinical improvement, objective cognitive testing declined during the same period. Two AI systems (Claude and Perplexity) independently analyzed neuroimaging reports, cognitive testing, and clinical data over 5-7 iterative cycles, systematically challenging each other's interpretations.

Results: Initial analyses diverged substantially (45-60 percentage-point difference in probability estimates). Through autonomous error detection and cross-validation, systems converged to a consensus (<10 percentage-point difference). Critical autonomous discoveries included: (1) 3.5% increase in total intracranial volume (physiologically impossible, indicating measurement artifact), (2) 11-month temporal gap between cognitive testing and MRI, and (3) literature review revealing hyperbaric oxygen therapy produces maximum 1-2% volumetric changes. Final consensus: modest real improvements (2-4%) embedded within measurement artifact (3-5%).

Conclusions: Dual-AI iterative consultation achieved autonomous error detection, literature integration, and convergent validity without requiring human identification of critical flaws. This approach may enhance reliability in complex clinical decision-making while maintaining appropriate physician oversight.

Keywords: artificial intelligence, clinical decision support, neuroimaging, automated volumetry, large language models, convergent validity, error detection.

Background: Kundalini Yoga (KY) integrates breathwork, meditation, dynamic movement, and chanting, and has gained recognition as a therapeutic intervention. Despite promising results from individual randomized controlled trials (RCTs), to our knowledge, no systematic review has exclusively synthesized RCT evidence on KY across health domains.

Objective: To critically assess the clinical effectiveness and safety of KY interventions across diverse cognitive, psychological, emotional, sleep-related, and physical health outcomes.

Methods: PRISMA-guided systematic review of RCTs evaluating KY was conducted from January 2015 to December 2024. Databases included MEDLINE (PubMed), Scopus, CENTRAL (Cochrane Library), Embase, PsycINFO, and CINAHL. Risk of bias was independently assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

Setting: Studies were conducted worldwide, across multiple sites.

Participants: Approximately 1370 participants ranging from healthy adults to those diagnosed with conditions such as Mild Cognitive Impairment (MCI), Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), insomnia, chronic pain, and post-treatment Lyme disease syndrome. No serious adverse events were reported.

Intervention: KY protocols (pranayama, asana/kriya, meditation, chanting) delivered in person, online, or hybrid formats; duration 6 weeks-12 months (most 8-12 weeks) with practice from once weekly to daily.

Outcome measures: Pre-specified validated measures assessed cognitive function, psychological symptoms (e.g., anxiety, depression), sleep quality, emotional regulation, and physical health outcomes (e.g., hippocampal metrics, absenteeism, blood pressure).

Results: This systematic review included 15 studies, among which 13 demonstrated a low risk of bias. The findings suggest that KY significantly improves memory, executive functioning, and hippocampal structure, reduces symptoms of anxiety, PTSD, OCD, and depression, enhances sleep quality and emotional regulation, and modestly improves fatigue, blood pressure, and functional outcomes.

Conclusion: KY appears safe and shows benefits for a wide range of cognitive, psychological, and physical health conditions. However, larger, standardized RCTs with active comparators, biomarkers, and longer follow-up are needed.

Keywords: Kundalini Yoga, randomized controlled trials, cognitive function, mental health, sleep, PTSD, hypertension, complementary therapy, mind-body intervention.

No Abstract Available.

No Abstract Available.

Context: The Lancet report of the CHAIN trial evaluating FYTF-919, a traditional Chinese medicine (TCM) for moderate to severe acute intracerebral hemorrhage, concluded "no effect" on functional recovery, survival, and health-related quality of life compared to placebo.

Objective: The current study intended to re-examine its methodology and conclusions about the efficacy of FYTF-919.

Design: Reanalysis of data from the Lancet report.

Intervention: Adopting the PICO framework and the CONSORT Extension, a critical appraisal of the trial's report and supplementary materials was conducted. Definition of TCM-specific patterns, sample size calculation, use of multiple concomitant therapies, timing of primary outcome assessment, and interpretation of results have been examined.

Results: There was a risk of performance bias in the trial as it did not report TCM-specific patterns, despite FYTF-919 being formulated for qi deficiency, potentially including patients unsuitable for this intervention. The sample size calculation was flawed and inconsistently applied, altering the mean difference and potentially underestimating FYTF-919's effect. Both the FYTF-919 and placebo groups had 19 concomitant therapies applied as needed, making it difficult to isolate FYTF-919's benefits. The study mistakenly hypothesized that there was no difference between the two groups due to the use of the 19 concomitant therapies, referred to as "routine treatment". The main report ignored multiple significant differences in subgroups and at earlier timepoints. These potentially positive findings were not highlighted, raising concerns of a substantial risk of selective reporting bias.

Conclusions: The trial's conclusion of "no effect" is questionable due to methodological flaws, trial design, and reporting errors. Proper assessment of complex interventions, clearer adherence to TCM-specific guidelines, rigorous sample size calculation, and balanced consideration of early recovery data and subgroups are essential. The current analysis of the appraisal found that the effect of the FYTF-919 was superior to that of the placebo.

Keywords: Intracerebral hemorrhage, Traditional Chinese Medicine, FYTF-919, multiple interventions, CHAIN trial, selective report bias, critical appraisal, Zhongfeng Xingnao.

Background: Obesity is a health condition characterized by excessive fat accumulation in the body, which adversely affects life expectancy and leads to various health issues. Conventional medical interventions involve pharmacological treatments and invasive procedures, which have risks and side effects. Recent studies have investigated the efficacy of moxibustion with other therapies for obesity management.

Objectives: This study aimed to investigate the metabolic effects of moxibustion on obesity using a gas chromatography-mass spectrometry (GC-MS)-based metabolomic approach.

Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups: Normal (standard diet), Control (obesity-induced without treatment), CV12 (obesity-induced with moxibustion at CV12 acupoint), and ST36 (obesity-induced with moxibustion at ST36 acupoint). The remaining two standard diet groups were presented as reference data in the supplementary materials. Following eight weeks of high-fat diet induction, moxibustion treatment was applied three times per week for an additional eight weeks, totaling 24 sessions in the CV12 and ST36 groups. Fecal metabolomic profiling was performed using GC-MS, and pathway enrichment analysis was conducted to identify metabolic alterations.

Results: Moxibustion at CV12 resulted in significant improvements in body weight and fat accumulation, whereas ST36 primarily contributed to metabolic modulation, reflecting distinct physiological impacts of each acupoint. Metabolomic analysis revealed distinct metabolic alterations, with the CV12 and ST36 groups exhibiting increased levels of ribose and xylitol, whereas the Control group showed elevated levels of 3-hydroxybutyrate and hypoxanthine. Pathway enrichment analysis reveals acupoint-specific metabolic modulations, with CV12 primarily influencing lipid and carbohydrate metabolism (via pentose phosphate and butanoate pathways), while ST36 affected amino acid metabolism (via arginine, proline, and histidine pathways).

Conclusion: These findings suggest that moxibustion exerts acupoint-dependent metabolic effects, with CV12 acupoint targeting lipid metabolism and ST36 acupoints modulating amino acid pathways. The results highlight the potential of moxibustion as a non-invasive intervention for obesity management, warranting further clinical validation.

Keywords: gas chromatography-mass spectrometry, metabolomics, moxibustion, obesity, metabolic pathway.

Background: This case study examines the effects of diindolylmethane (DIM) on lowering Prostate-specific antigen (PSA) levels and improving hormonal balance in a 78-year-old male patient. It further considers whether the timing of hormonal changes in relation to DIM use suggests a possible causal link. The patient presented with steadily rising PSA levels and declining testosterone, raising concerns about potential prostate pathology. Given his reluctance to undergo a prostate biopsy-due to concerns about its invasiveness and potential complications-a functional medicine approach was adopted to address the hormonal imbalances contributing to his condition. The intervention included discontinuing cholesterol-lowering supplements and introducing 100 mg per day of DIM-Evail™ for three months to modulate estrogen metabolism. Over the three months, the patient's PSA dropped from 4.6 to 2.4 ng/mL, while the total and free testosterone notably increased from 436 ng/dL to 615 ng/dL. This case highlights the potential of targeted nutraceutical interventions in modulating hormone metabolism and supporting prostate health, though, as a single case, the findings warrant further validation through larger clinical studies.

Keywords: Diindolylmethane (DIM), Prostate-specific antigen reduction, aromatase inhibition therapy, estrogen metabolism modulation, testosterone restoration, prostate cancer risk biomarkers, nutraceutical intervention for elevated prostate-specific antigen.

Abstract: This case report evaluates the effectiveness of botanical oral health products in managing bacterial overgrowth and enhancing gingival and periodontal health in a 34-year-old female patient with mild-to-moderate gingivitis. The patient presented with bleeding on probing and positive pathogenic bacterial culture testing. The treatment regimen included a botanical toothpaste and oral rinse (Dentalcidin® and Dentalcidin® LS), oral probiotic, and dysbiosis protocol (Bioclear® Microbiome Detox Program). Post-treatment assessments revealed significant reductions in bleeding on probing and a marked decline in bacterial colony counts, indicating improved microbial balance. The bleeding index was reduced from 21% to 4% after six months, and from 4% to 1% during the subsequent three months using a botanical toothpaste and oral rinse. Periodontal pathogens that were present pre-treatment at high-risk levels were reduced to low-risk levels. These findings suggest that botanical oral health products can reduce bacterial overgrowth and improve periodontal parameters, offering a viable alternative to conventional therapies.

Keywords: case report, oral microbiome, biofilm, oral dysbiosis, Tannerella forsythia, Fusobacterium nucleatum, herbal (botanical) medicine.

Background: Increasing evidence suggests the effectiveness of virtual reality (VR)-based neuro-rehabilitation. However, the evidence is not well defined, specifically for progressive neurological disorders.

Primary study objective: This study aimed to determine the efficacy and safety of VR therapy over conventional therapy in treating progressive neurological disorders in adults.

Methods/design: The study comprises a systematic review and a meta-analysis, following the PRISMA guidelines, and was registered with PROSPERO (CRD42024582827). Relevant literature was searched in electronic databases including Scopus, Web of Science, PEDro, PubMed, Cochrane Library, and Google Scholar. Seven articles were meticulously selected after eliminating irrelevant ones based on inclusion and exclusion criteria. The PEDro scale was used to assess the methodological rigor of the selected studies. The risk of bias was evaluated using the Cochrane's Risk of Bias 2 tool.

Setting: Within an academic research context, the published studies from the databases were used for this study.

Participants: No participants were directly recruited; this review included participants reported in the included studies.

Intervention: VR therapies (non-immersive or semi-immersive) were compared with conventional therapy as reported in the original studies.

Primary outcome measures: Measuring motor rehabilitation of upper or lower limbs, balance, quality of life (QoL), and adverse effects.

Results: Both groups demonstrated improvement in analyzed parameters (e.g., motor functions, balance, and QoL). No difference was found in motor function measures between groups. The QoL measures insignificantly favored the VR group, while the balance measures significantly favored conventional therapy. Moreover, VR therapy was not significantly linked with adverse effects, except for some minor reactions.

Conclusion: Non-immersive or semi-immersive VR was at least on par with conventional therapy for assessed outcome measures, except for the balance measures, which significantly favored conventional therapy.

Keywords: virtual reality, progressive neurological disorders, neurodegenerative diseases, neurological rehabilitation, systematic review, comparative effectiveness research.

Background: Dysregulated activation of macrophages through the Toll-like receptor 4 (TLR4) pathway plays a central role in the pathophysiology of numerous inflammatory diseases. The immunomodulatory potential of AYUSH-64, a polyherbal formulation, has recently gained renewed interest. However, the individual contributions of its constituent botanicals, Alstonia scholaris (AS), Picrorhiza kurroa (PK), Swertia chirata (SC), and Caesalpinia crista (CC), remain poorly characterized.

Objective: To evaluate and compare the prophylactic immunomodulatory effects of AYUSH-64 and its individual plant extracts on lipopolysaccharide (LPS)-induced inflammation in THP-1-derived macrophage-like cells.

Methods: THP-1 monocytes were differentiated using phorbol 12-myristate 13-acetate (PMA) and subsequently stimulated with LPS (100 ng/mL) to activate TLR4 signaling. Before stimulation, cells were pre-treated with AYUSH-64 or its individual extracts (AS, PK, SC, and CC) at concentrations of 30, 100, and 300 µg/mL. Dexamethasone (30 nM) was used as a positive control. Gene expression of pro-inflammatory and regulatory cytokines (TNF-α, IL-1β, and IL-10) was quantified using qRT-PCR, and cytokine secretion levels via ELISA.

Results: All treatments, including AYUSH-64 and the individual botanical extracts, were non-cytotoxic to PMA-differentiated THP-1 cells. AYUSH-64 elicited a moderate suppressive effect on TNF-α and IL-10 at both the transcriptional and protein levels, with minimal impact on IL-1β expression. In contrast, individual extracts specifically SC, PK, and CC, demonstrated more pronounced and selective inhibition of inflammatory markers. Notably, SC and PK significantly reduced IL-10 secretion, achieving effects superior to those of dexamethasone. AS showed strong downregulation of TNF-α and IL-10 gene expression, while CC induced a dose-dependent reduction in IL-10 expression and secretion.

Conclusion: Individual components of AYUSH-64, especially SC, PK, and CC, demonstrate stronger and more selective anti-inflammatory effects in vitro. They outperformed AYUSH-64 in reducing IL-10 secretion. Thus, constituent-level evaluation in polyherbal formulations is warranted, though further in vivo and clinical studies are needed to confirm their therapeutic potential.

Keywords: AYUSH-64, Alstonia scholaris, Picrorhiza kurroa, Swertia chirata, Caesalpinia crista, toll-like receptor 4, inflammation, macrophage.