BMC Complementary Medicine and Therapies最新文献

Background: Bitter kola, Garcinia kola Heckel, is a woody plant native to West and Central Africa. It is traditionally used both in social ceremonies and for treating a wide range of ailments, including malaria, respiratory infections, gastrointestinal disturbances, hepatitis, metabolic and sexual disorders. Despite its importance and popularity, a great deal of information and basic knowledge is still missing about the species. Particularly lack of studies is related to therapeutic efficacy and safety of bitter kola uses.

Aims: This study aimed to document ethnomedicinal uses of bitter kola among native populations in Nigeria, to identify commonly used plant parts and the dosages, record perceived side effects and to compare these findings with scientific evidence, and to estimate its potential clinical applications.

Methods: Data were collected by a structured questionnaire distributed both online and in-person to members of the Nigerian public.

Results: A total of 152 respondents participated, primarily from the Ibibio, Annang, and Igbo ethnic groups. Most participants reported using fresh seeds of bitter kola, mainly for treating respiratory symptoms, stomach upset, and general well-being. Regular use was common, typically, monthly or as needed, depending on the disease.

Conclusions: Several traditional uses of bitter kola are supported by clinical studies: including its antioxidant and immunomodulatory effects and its benefits for gastric, hepatic, glycemic, respiratory, reproductive and pain-modulation related conditions. Evidence also suggests antimicrobial and hepatoprotective potential. However, further studies are required to establish standardised dosages and safety profiles for different plant parts.

Background: Acupuncture has been widely applied to polycystic ovarian syndrome (PCOS) patients. This network meta-analysis (NMA) aims to compare the effects of different acupuncture methods on PCOS from the aspects of hyperandrogenism, metabolic status, sexual hormone disturbance, and infertility.

Methods: We searched eight electronic databases for randomized controlled trials on different acupuncture methods vs. placebo or standard treatment by the end of 30 October, 2023. Stata17 and R 4.5.2 were used for a Bayesian NMA, and Cochrane RoB 2.0 tool for the methodological quality assessment of the included studies.

Results: A total of 59 studies (5937 participants) were included. In terms of hyperandrogenism, acupuncture greatly reduced testosterone levels in PCOS patients compared with medicine (mean difference(MD)): 0.69; 95% credible interval [0.35, 1.03]). Based on surface under the cumulative ranking curve (SUCRA), acupoint catgut embedding (ACE) was the most recommended in decreasing testosterone levels(SUCRA = 81.7%). Compared with placebo, electro-acupuncture (E-acupuncture) was significantly effective in decreasing Ferriman-Gallwey scores in PCOS patients (MD: 1.52; 95% CrI [0.50, 2.53]), and it was also the preferred choice for reducing Ferriman-Gallwey scores (SUCRA = 84.9%). In terms of metabolic status, ACE was regard the most recommended in reducing body mass index (SUCRA = 90.9%) and waist hip rate (SUCRA = 95.3%); acupuncture was considered as the top preferred option in reducing triglyceride (SUCRA = 79.3%) and high-density lipoprotein (SUCRA = 54.8%); E-acupuncture was possibly the preferred choice for reducing low-density lipoprotein (SUCRA = 75.2%) and fasting blood glucose (SUCRA = 64.6%), and medicine was the preferred choice for reducing homeostasis model assessment of insulin resistance. For sexual hormone disturbance, ACE served as the most recommended option in reducing luteinizing hormone (LH) (SUCRA = 73.3%) and LH/follicle-stimulating hormone(FSH) ratio (SUCRA = 80.9%). For infertility, acupuncture acted as the preferred choice in increasing the pregnancy rate (SUCRA = 76.6%). Sensitivity analyses indicated that the results were generally robust.

Conclusions: No single acupuncture method is the optimal method for all indicators in PCOS patients. Clinically, clinicians may select acupuncture treatment based on patients' primary clinical concerns, acknowledging the limitations of current evidence and individualizing treatment decisions. These findings remain to be further verified by rigorously designed studies due to limitations of existing clinical studies and evidence.

Background: Squalene, a natural isoprenoid and an intermediate in cholesterol synthesis, has anti-inflammatory and skin-protective effects. The aim of the present study was to investigate the impact of squalene on the cellular viability of human gingival fibroblasts (HGF), and wound closure, the expression levels of transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), type-I and type-III collagen in an in vitro wound healing model.

Methods: Squalene was used at concentrations of 10 µM (SQ1 Group) and 100 µM (SQ2 Group). The cell viability cytotoxicity to HGF was assessed using the MTT assay at 24, 48, and 72 hours. Scratch assay was used to evaluate wound healing at baseline, 24, 48, and 72 hours. The expressions of TGF-β, VEGF, type-I and type-III collagen were evaluated using the ELISA at 24, 48 and 72 hours.

Results: No cytotoxic effects were observed in groups. A significant reduction in remaining wound area was observed in the SQ2 group at 24 hours and in both the SQ1 and SQ2 groups at 48 hours compared to the control group (p < 0.05). TGF-β was higher in the SQ2 group compared to the control group at 24 hours (p < 0.05), and at 48 hours, TGF-β levels in the SQ1 group were higher than both the control and SQ2 groups (p < 0.05). In type-I collagen, at 48 hours, both SQ1 and SQ2 groups exhibited higher levels compared to the control (p < 0.05). Type-III collagen levels were greater in the SQ1 group than in both the SQ2 and control groups at 48 hours (p < 0.05).

Conclusions: Considering its non-cytotoxic profile on HGF and its effects on TGF-β, type-I, and type-III collagen expression, squalene appears to facilitate wound healing by promoting wound closure.

Background: Low Back Pain (LBP) is the leading cause of disability worldwide, 90% of which is nonspecific. Manual therapy is one of the recommended treatment modalities. However, reported outcomes may be variable. This review aims to identify their scope in the context of the development of a Core Outcome Set (COS), which is defined as « an agreed standardised set of outcomes that should be measured and reported, as a minimum, in all clinical trials in specific areas of health or health care ».

Methods: A scoping review with risk of bias assessment of randomised controlled trials (RCTs) of manual therapy for nonspecific LBP was conducted using MEDLINE, CENTRAL, PEDro, WebOfScience and ClinicalTrials.gov, from 2010 up to August 2024. Manual therapy was considered the use, alone or in combination, of manipulations (high velocity, low amplitude), mobilisations (low-grade velocity, small-to-large amplitude) or soft tissue relaxation (especially massage, trigger points, muscle contractions).

Results: Out of 3929 articles, 147 RCTs and 74 protocols were included. Two main outcomes emerged: pain intensity (assessed by numerical rating scale or visual analogue scale) and disability (mostly assessed by Rolland-Morris Disability Questionnaire or Oswestry Disability Index). Range of motion is the most frequent clinical outcome assessed. Psychological factors such as fear-avoidance beliefs, kinesiophobia and catastrophising, and healthcare consumption, particularly medication, are also frequent. Most of the outcomes were patient-reported outcomes.

Conclusion: Consistent with a previous COS on nonspecific low back pain, manual therapy appears to address the same outcomes. Clinical trials in manual therapy should focus on using the existing COS by measuring pain intensity using a numerical rating scale, disability using the ODI 2.1a or the 24-item RMDQ, health-related quality of life using the SF-12 or the 10-item PROMIS. Additionally, due to the gap between clinical research and pain experience, trials should consider conducting subgroup analyses to identify effects on outcomes related to gender or age, paying particular attention to health inequalities by carrying out analyses based on socioeconomic status, as these factors are well known to significantly impact pain experience and access to care.

Review protocol: PROSPERO registration CRD42024576475, COMET Database registration 3229.

Background: Previous surveys suggest women are taking a variety of herbs during their pregnancy. One herb that has been used for centuries for pregnancy is raspberry leaf (Rubus idaeus). There is a need to update our understanding of the motivations and experiences of women using raspberry leaf specifically during their pregnancy. This paper also sheds light on the current prevalence of herbal medicine use in pregnancy in Australia.

Methods: A prospective cohort design, collecting data by survey and routinely collected clinical data, was implemented. This paper reports on the secondary aims, from a cross-sectional survey nested within this study, which provided both the prevalence of herbal use in pregnancy (n = 561) and women's motivations and experiences of using raspberry leaf specifically in pregnancy (n = 46).

Findings: Most women (68%) reported taking one or more herbal medicine/s during their pregnancy. Raspberry leaf was the most common herb reported, with more than a third (37%) of the cohort reporting use of the herb. The most common reason for using raspberry leaf during pregnancy was to make labour easier. Most women claimed that taking raspberry leaf in pregnancy was a positive experience. Analysis of open text responses focusing on the experience of taking raspberry leaf, revealed four categories: Ritual, Comforting, Necessary, Self-Determined.

Conclusion: This study identified a larger percentage of women taking herbal medicine in pregnancy than has been reported in older surveys in Australia. Raspberry leaf was considered a 'necessary' part of women's 'ritual' while pregnant that contributed to their 'self-determination.' Raspberry leaf is important to some women's personal preparation for labour.