BMC Complementary Medicine and Therapies最新文献

Purpose: Continuous positive airway pressure (CPAP) therapy remains the cornerstone of obstructive sleep apnea (OSA) treatment, considerably reducing the risk of cardiovascular complications and improving patient outcomes. However, adherence to CPAP therapy is a major challenge and poor compliance limits its efficacy. This study investigated the potential of aromatherapy, a noninvasive, cost-effective intervention, to improve CPAP adherence and enhance sleep quality in patients with OSA.

Methods: A prospective observational pilot study was conducted in patients with obstructive sleep apnea who demonstrated poor CPAP adherence (< 70% usage and < 4 h/night). Participants were exposed to lavender or cypress aroma oil during sleep. Pre- and post-intervention subjective sleep measures Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and objective CPAP usage metrics were collected. Normally distributed variables were analyzed using paired t-tests, and non-normally distributed variables were analyzed using the Wilcoxon signed-rank test. Statistical significance was set at p < 0.05. A post hoc power analysis was performed based on observed effect sizes for the primary outcomes.

Results: Eight patients with OSA (mean age 53.5 years; 4 males, 4 females) participated in the study. Following 67 days of treatment, the median PSQI score significantly improved from 9.0 to 6.5 (p = 0.006), and the median ESS score decreased from 9.0 to 6.5 (p = 0.034). Additionally, CPAP for more than 4 h increased from 5.0% to 25.7% (p = 0.028). The median usage duration improved from 149 to 231 min (p = 0.018). No significant change in apnea hypopnea index (AHI) was observed during CPAP use, decreasing from 3.2 events/h to 1.3 events/h (p = 0.226), which is consistent with the understanding that appropriately applied CPAP maintains effective control of respiratory events.

Conclusion: Aromatic stimulation with essential oils shows promise in improving both CPAP adherence and sleep quality, offering a novel approach to enhance OSA treatment efficacy.

Background: Chronic non-specific low back pain lacks a defined pathoanatomical cause, leading to diverse treatment methods including physiotherapy and complementary alternative medicine techniques such as Tuina. This study aimed to evaluate the effectiveness of Tuina for managing chronic non-specific low back pain by comparing it to physiotherapy and a combination of physiotherapy and Tuina.

Methods: In this randomized, parallel-controlled, single-blind trial, 204 participants aged 21 to 75 with chronic non-specific low back pain were randomly assigned to physiotherapy, Tuina, or combined therapy. Pain intensity and quality of life were measured with the visual analog scale, 36-Item Short Form Survey and the Oswestry Disability Index, alongside trunk range of motion. Outcomes were assessed at baseline, two months, and five months. Data were analyzed using analysis of variance for within- and between-group comparisons, and post-hoc tests were applied to between-group comparisons.

Results: After two months, all groups had significant improvement in pain scores. Tuina was only significantly better than the combination treatment for reducing pain (p = 0.021; mean difference = - 1.04 [95% CI - 1.85 to - 0.23], Cohen's d = - 0.41). However, no significant difference was observed between Tuina and combined treatment against physiotherapy. Pain scores were not significantly different at five months in all groups. The physiotherapy (p = 0.019; mean difference = - 5.28 [95% CI - 9.44 to - 1.11], d = - 0.44) and combined (p = 0.028; mean difference = 5.59 [95% CI 1.17 to 10.01], d = 0.42) groups showed a significant reduction in Oswestry Disability Index scores compared to Tuina at five months. The combined group had significantly greater 36-Item Short-Form Survey than Tuina (p = 0.012; mean difference = - 71.15 [95% CI - 118.23 to - 24.06], d = - 0.47), but not significantly greater than physiotherapy.

Conclusions: All treatment groups demonstrated improved outcomes post-intervention and at five months. Between-group differences in improvement were significant only for Oswestry Disability Index and 36-Item Short-Form Survey scores at five months. Pain scores showed no significant superiority of physiotherapy over Tuina and combined therapy (d < 0.2), indicating potential use of Tuina in chronic non-specific low back pain management.

Trials registration: ChiMCTR2000004087.  URL: https://www.chictr.org.cn/showprojEN.html?proj=62614 .  Date of Registration: 27 November 2020.

Background: Metabolic syndrome (METS) is a multifactorial cardiometabolic disorder characterized by abdominal obesity, insulin resistance, hypertension, dyslipidemia, and hyperglycemia, substantially increasing the risk of type 2 diabetes and cardiovascular diseases. The variable effectiveness of lifestyle and pharmacological interventions has heightened interest in complementary approaches. Hirudotherapy, containing a wide range of bioactive compounds, may offer therapeutic benefits. This study aimed to evaluate the effects of hirudotherapy on metabolic parameters in a rat model of METS.

Methods: Twenty-four male Wistar rats were divided into four groups: Control (n = 6), METS (n = 6), METS + 4-week hirudotherapy (n = 6), and METS + 8-week hirudotherapy (n = 6). METS was induced through a modified high-fat and fructose-enriched diet. The effects of hirudotherapy on liver enzymes (AST, ALT), lipid profile (TG, LDL cholesterol, HDL cholesterol), hemodynamic parameters (systolic/diastolic blood pressure, mean arterial pressure, heart rate), glucose metabolism (OGTT, AUC), and liver histopathology were assessed. Pellet and water intake were monitored to evaluate possible influences on appetite regulation.

Results: Hirudotherapy demonstrated hepatoprotective activity, yielding significant reductions in AST and ALT levels (p < 0.05). TG levels increased in METS, while LDL cholesterol showed partial improvement and HDL cholesterol remained unchanged. Systolic blood pressure significantly decreased in the hirudotherapy-treated groups, with no significant differences in diastolic pressure or heart rate. OGTT and AUC analyses revealed improved glucose tolerance and reduced hyperglycemia following hirudotherapy (p < 0.05). Histopathology showed marked improvements in steatosis, sinusoidal dilatation, and hydropic degeneration, although minor hemorrhagic foci persisted. Differences in pellet consumption suggested a potential regulatory effect on appetite and metabolic balance.

Conclusion: Hirudotherapy may exert beneficial effects in METS by improving liver function, modulating lipid metabolism, enhancing insulin sensitivity, and reducing inflammation. Its influence on food intake may further support metabolic homeostasis. These findings support hirudotherapy as a potential biotherapeutic approach and warrant further mechanistic and clinical investigations.

Background: NETosis, a specialized form of neutrophil cell death, plays a dual role in immune regulation. While NET formation is essential for capturing pathogens, excessive NETosis contributes to immunothrombosis, oxidative stress, and tissue damage, affecting both acute and chronic diseases such as COVID-19, cardiovascular diseases, diabetes, cancer, and autoimmune conditions. Given the limitations of current treatments, including toxicity, high costs, and bleeding risks, phytochemicals are being explored for their therapeutic potential.

Methods: NETosis gene sets were collected through published data, and followed by Gene set enrichment analysis (GSEA) to identify potential NETosis-inhibiting natural compounds from a library of 103 phytochemicals candidates. NETosis phenotype was confirmed by assessing NET formation through immunofluorescence staining and quantification. Candidate compounds were further validated in vitro using RT-qPCR to assess the expression of NETosis-related genes, including PADI4, TREM1, S100A8/A9, and CCL7. To evaluate the procoagulant consequences of NETosis, we performed a thrombin activity assay by incubating plasma with conditioned media from treated neutrophil-like cells.

Results: Three phytochemicals-hesperidin, baicalin, and imperatorin-were identified as effective inhibitors of NETosis. Immunofluorescence staining confirmed NET inhibition, and RT-qPCR analysis showed significant downregulation of key genes involved in NET formation. In addition, thrombin activity was significantly reduced in plasma exposed to conditioned media from phytochemical-treated cells, indicating attenuation of NETosis-associated procoagulant activity.

Conclusions: Hesperidin, baicalin, and imperatorin show promise as candidates for modulating NETosis, with implications for managing immunothrombosis and chronic diseases.