Alternative therapies in health and medicine最新文献

Background: Psoriasis remains an incurable and recurrent condition despite modern treatment. Traditional Unani Medicine recommends numerous formulations for psoriasis, but with little supporting scientific evidence.

Primary study objectives: The study aimed to evaluate the efficacy and safety of Majoon Mundi and Roghan Gul compared to apremilast and coconut oil in managing chronic plaque psoriasis (CPP).

Methods/design: The study was a randomized, open-label, standard-controlled clinical trial, with 33 participants. 20 patients completed the 6-week treatment course in the test group, while 10 patients completed the 6-week treatment course in the control group.

Setting: The study was conducted at the National Institute of Unani Medicine (NIUM), Bangalore, India, from June 2021 to December 2021.

Participants: Participants aged 18-60 years, of either gender, diagnosed with CPP, and based on psoriasis area and severity index (PASI) score.

Interventions: The participants in the test group received 10 g of Majoon Mundi orally twice daily after meals and Roghan Gul for topical use twice daily, while the participants in the active control group received apremilast orally in a titrated dose and coconut oil as a topical application twice daily.

Outcome measures: The primary outcome of the study was a reduction in PASI score, and the secondary outcome was a reduction in dermatology life quality index (DLQI) score. Photographic assessments were conducted at the 14th, 28th, and 42nd day of the follow-up period.

Results: Intragroup analyses revealed that the test and control groups experienced a statistically significant reduction in PASI and DLQI scores (P < .001). Intergroup analysis showed no statistically significant difference in the reduction of PASI and DLQI scores between groups (P = .772 and .775, respectively).

Conclusion: This study found that together, Majoon Mundi and Roghan Gul are as effective as apremilast and coconut oil in decreasing PASI and DLQI scores for managing CPP.

Keywords: apremilast, comparative study, herbal medicine, psoriasis, unani medicine.

Background: Chronic kidney disease (CKD) is a progressive condition often associated with hypertension and diabetes, leading to impaired renal function and poor quality of life.

Objective: This study employed alternative and holistic approaches to enhance kidney function in a 56-year-old male diagnosed with CKD in 2021, hypertension in January 2021, and diabetes mellitus type 2 in 2022, who presented with worsening renal function and back pain symptoms.

Study design: Single-patient case study at a single centre.

Intervention: A 12-day intervention based on an integrated naturopathy and yoga approach was provided, which included therapeutic yoga, diet, hydrotherapy, manipulative, and relaxation techniques.

Setting: Sri Dharmasthala Manjunatheshwara Yoga and Nature Cure Hospital, Dharmasthala, India.

Outcome measures: General parameters (weight and body mass index), blood pressure (systolic and diastolic), kidney profile (creatinine and urea), urine profile (protein and sugar), blood glucose (fasting blood sugar and postprandial blood sugar), and pain (using Visual Analog Scale).

Results: Post-treatment evaluation showed a notable improvement in his fasting blood sugar (15%), postprandial blood sugar (32%), blood pressure (~10%), serum creatinine (32%), proteinuria, glycosuria, and pain score relief (60-80%).

Conclusion: This suggests that an integrated yoga and naturopathy approach may be considered an alternative or adjunct treatment for managing CKD. However, additional research is needed to validate these findings.

Keywords: chronic kidney disease, yoga, naturopathy, diet, case study.

Background: Sciatica is a type of musculoskeletal pain experienced in the leg along the distribution of the sciatic nerve. It is occasionally accompanied by lower backache. According to the Unani system of medicine, Irq al-Nasa (Sciatica) is a form of Wajaul Mafasil (Arthritis), characterised by hip pain that travels from the back of the thigh to the ankle joint. Conventional treatments for Sciatica typically involve medication, surgery, or occasionally both. The use of corticosteroids and painkillers is associated with a higher risk of adverse events, and their effectiveness is also questionable. This warrants the need for an effective, complementary treatment option for Sciatica.

Aim: This case report aims to evaluate the efficacy of Fasd (Venesection) in managing Irq al-Nasa.

Case description: The patient was a 63-year-old non-hypertensive, non-diabetic, euthyroid male, complaining of persistent left-sided pain in the upper thigh, lower buttock region, with pain radiating to the left leg, calf, and toes, along with numbness and tingling sensations. Sciatica was diagnosed based on three objective criteria: Visual Analogue Scale (VAS) pain score, Oswestry Disability Index (ODI), and Straight Leg Raising Test (SLRT), as well as from magnetic resonance imaging (MRI) of the lumbo-sacral spine.

Intervention: Fasd (Venesection) was performed on the left saphenous minor vein of the patient once a week for two weeks. The patients were assessed using VAS, ODI, and SLRT.

Outcome: Before the intervention, the VAS score was 8, the ODI was 42%, and the SLR was 30%. Following the first Fasd procedure, the VAS score decreased to 4, the ODI reduced to 22%, and the SLR improved to 60%. After the second procedure, the VAS score reached 0, the ODI further dropped to 8%, and the SLR increased to 90%.

Conclusion: This case report provides preliminary evidence supporting the use of Fasd in treating Sciatica.

Keywords: Fasd, Venesection, Sciatica, Irq al-Nasa, pain management, case report.

Background: Asthma and chronic obstructive pulmonary disease (COPD) are prevalent respiratory conditions with overlapping pathogenic features such as chronic inflammation.

Primary study objective: This study aimed to identify key contributors and pathways that are common to both of these disorders, potentially allowing for the detection of therapeutic targets, particularly for patients with asthma-COPD overlap syndrome.

Methods: Using an integrated transcriptomics approach, eight datasets were analyzed, including two each for COPD and asthma, in both blood and airway epithelial cells. Thereafter, by identifying shared differentially expressed genes between COPD and asthma, protein-protein interaction and miRNA-mRNA regulatory networks were constructed for blood and epithelial cells, and hub genes were determined. Lastly, functional enrichment analysis was conducted to determine the biological functions of the discovered shared protein-protein interaction (PPI) networks.

Results: The construction of shared PPI networks for these two respiratory disorders highlighted key hub genes, including ribosomal proteins and IL-1β in blood and CTNNB1 in airway epithelial cells. Two members of the miR-30 family, including miR-30a-3p and miR-30e-3p, were discerned as multi-target regulators of hub genes in both networks of blood and airway epithelial cells. Infection-related pathways were substantially enriched, as revealed by functional analysis of shared networks for both blood and airway epithelial cells.

Conclusion: IL-1β signaling may serve as a potential link between asthma and COPD, since it was identified as a hub gene in the shared network of blood. Likewise, downregulated CTNNB1 was discerned as a key gene in the shared network of airway epithelial samples.

Keywords: asthma, chronic obstructive pulmonary disease, transcriptome, gene expression profiling, systems biology.

Background: Research quality in Ayush systems of medicine is vital for evidence synthesis and decision-making. As Ayush gains global recognition, analyzing its trends and challenges is important for improving clinical outcomes. However, a comprehensive analysis of research publications is lacking.

Primary study objective: We conducted a bibliometric analysis using data from the Ayush research portal to highlight key trends and challenges in this field.

Methods: We extracted data from the Ayush Research Portal (ARP) database for the years 1954 to 2020, excluding books, workshops, conference papers, and incomplete entries. Our analysis evaluated the types of Ayush systems, authors' countries, publication years, author contributions, and the predatory status of journals. We used Epi Info (version 7.2) and Quantum GIS software for data analysis and map creation.

Results: We included 24 037 articles for analysis. Our findings indicate a gradual increase in publications starting from 2000, followed by exponential growth from 2009, and a peak in 2011. Most articles focused on preclinical research (n=10 677; 44.0%). India leads in the quantity of publications (n=20 675; 86.0%), followed by the US (n=649; 2.7%). Within India, Tamil Nadu accounted for the highest number of publications (n=3517; 17.0%). Furthermore, approximately 10% of the journals and one-third of the articles (7268; 30%) were classified as predatory.

Conclusion: This bibliometric review highlights a rise in publications across all systems, but raises concerns about quality, with one-third appearing in predatory journals. Thus, the Ayush systems of medicine should focus more on publication quality.

Keywords: complementary therapies, Ayurveda, traditional medicine, Ayush research portal.

Background: Cystoscopy causes pain, anxiety, and dissatisfaction in patients and leads to increased discomfort. Therefore, it is helpful to use pharmacological and evidence-based complementary alternative medicine methods together for pain, anxiety, and comfort management during the cystoscopy procedure.

Objective: This randomized controlled experimental study was conducted to determine the effects of heat application on patients' pain, anxiety, and comfort levels during cystoscopy.

Methods: This study was conducted as a two-parallel group randomized controlled trial, from November 2023 to June 2024.

Setting: The study was conducted in the cystoscopy unit of a state hospital located in Western Turkey.

Participants: The study sample consisted of 62 patients.

Intervention: The patients were randomly assigned to two groups using a computer program (www.randomizer.org): Group 1 (control group) and Group 2 (intervention group). The patients in the intervention group underwent heat application in the cystoscopy room.

Primary outcome measures: Data were collected using the 'Patient Information Form', 'Visual Analog Scale', 'Data Recording Form', 'State Anxiety Inventory', and 'Shortened General Comfort Scale'. While the data were analyzed, descriptive statistical methods, chi-square analysis, independent samples t test, dependent samples t test, and analysis of variance test were used.

Results: There was a statistically significant difference between the intervention and control groups in terms of the mean scores obtained from the VAS during and after the intervention, but there was no statistically significant difference between the scores obtained from the overall State Anxiety Inventory and Shortened General Comfort Scale and their subscales before and after the intervention.

Conclusion: The study findings indicate that the heat application to patients during cystoscopy is effective in reducing pain.

Keywords: anxiety, comfort, cystoscopy, heat application, pain, complementary and alternative medicine.

Background: Cupping Therapy is an ancient therapeutic practice used to treat a wide variety of medical conditions.

Aim: The study aimed to systematically review randomized controlled and quasi-experimental studies evaluating the effectiveness of cupping therapy on metabolite outcomes, specifically blood glucose, blood pressure, and lipid profiles in women.

Methods: The systematic review was conducted following PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A comprehensive literature search was carried out between January and May 2024 using PubMed, Web of Science, Scopus, CINAHL, and the Cochrane Library. Inclusion and exclusion criteria were determined using the PICOS framework, and the quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool.

Results: The analysis included data from 307 female participants who met the inclusion criteria and participated in six randomized controlled or quasi-experimental studies. The findings indicated that cupping therapy had a positive effect on several metabolic parameters. Significant associations were observed between cupping therapy and improvements in blood pressure, blood glucose levels, and lipid profiles. None of the included studies reported adverse effects related to cupping therapy in women.

Conclusion: Cupping therapy can improve blood pressure, blood glucose, and lipid levels in women. However, further high-quality studies with larger sample sizes, rigorous randomization, and blinding are needed to fully understand the therapeutic potential and mechanisms of action of cupping therapy.

Keywords: cupping therapy, metabolite results, systematic review, wet cupping therapy, women.

Background: Odontogenic infections are among the most common problems encountered in usual dental practice. The role and efficacy of complementary treatments such as individualized homeopathy are not well characterized.

Methods: A double-blind, randomized, placebo-controlled clinical trial enrolled 60 patients with uncomplicated odontogenic infections. Patients were randomly assigned to receive either Individualized Homeopathy (IH, n=30) or Placebo (PL, n=30), in addition to non-medicinal management. Co-primary outcome measures included Visual Analog Scales for Pain (VAS-P) and Swelling (VAS-S). Secondary outcome measures comprised the Oral Health Impact Profile-14 (OHIP-14) and time taken for complete symptom resolution (Ts). All outcomes were assessed at baseline, 3rd day, 7th day, and 14th day, except Ts, which was monitored daily until symptoms completely resolved within 14 days.

Results: IH showed significant improvement over PL in VAS-P at day 7 (P = .005) and day 14 (P < .001), as well as in VAS-S at day 7 (P = .001) and day 14 (P < .001). OHIP-14 improvement post-treatment was notably higher in IH than PL (F=3.404, P < .05). Kaplan-Meier analysis revealed a significant difference in Ts (P = .015), with reduced hazard in the PL group (Hazard Ratio = 0.3024, 95% CI: 0.1087-0.8414). The most prescribed medicines in the IH group were Mercurius solubilis (16.6%) and Hypericum perfoliatum (13.3%), whereas in the PL group, the most indicated medicines were Mercurius solubilis (13.3%) and Staphysagria (13.3%).

Conclusion: This study demonstrated a significant therapeutic effect of homeopathy over placebo in alleviating pain and swelling linked to odontogenic infections. Nevertheless, to firmly establish this finding, a large-scale replication trial employing a similar methodology is deemed necessary.

Keywords: homeopathy, odontogenic infections, randomized controlled trial, placebo, dental infections.