BMC Complementary Medicine and Therapies最新文献

Background: Subthreshold depression (SD), characterized by depressive symptoms not meeting major depressive disorder (MDD) criteria, poses a significant risk for MDD development. Acupuncture has shown promise for SD, though its efficacy beyond placebo remains unclear. Therefore, we designed this study to evaluate the efficacy of verum acupuncture (VA) compared to sham acupuncture (SA) for SD.

Methods: A randomized clinical trial was conducted at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China, from September 2021 to October 2023. Participants with SD were randomized 1:1 to receive either VA or SA for 8 weeks, with 12-week follow-up. The primary outcome was the change in Hamilton Depression Scale-17 (HAMD-17) scores from baseline to 8 weeks.

Results: Of 231 screened patients, 64 participants (71.87% female; mean age, 29.83 [SD 6.84] years) were included. Fifty-nine participants (92.2%) completed the study. The mean reduction in HAMD-17 scores from baseline to week 8 was -7.28 (95% CI, -8.26 to -6.3) in the VA group and -3.80 ( 95% CI, -4.42 to -2.77) in the SA group. The between-group difference at week 8 was -4.08 (95% CI, -5.15 to -3.02; P < .001). Effects persisted during the 12-week follow-up. No serious adverse events occurred.

Conclusions: Acupuncture demonstrated significant therapeutic effects for SD compared to SA, with benefits extending beyond placebo. These findings support acupuncture as a specific and effective intervention for SD. However, the study's limitations, including its single-center design and relatively young sample, should be considered when generalizing the results.

Trial registration: ChiCTR2100049660; Registered August 7, 2021.

Background and aims: Carotenoids are known for their beneficial effects in improving chronic diseases through their antioxidant properties. However, there has been no meta-analysis on the effects of carotenoids on liver enzymes and the evidence is inconsistent. So, this study aimed to evaluate the effects of carotenoid supplementation on liver enzyme levels in adults.

Methods: Through November 2024, the PubMed, Scopus and Web of Science electronic databases were searched for eligible trials evaluating the carotenoid supplementation effects on the Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP) and Gamma-glutamyl transferase (GGT). The 95% confidence intervals (CIs) and weighted mean differences (WMDs) were calculated using the random effects model. As part of standard methods, dose-response, meta-regressions, sensitivity, and publication bias analyses were performed. Evidence certainty was assessed using GRADE (Grading of Recommendations for Assessment, Development, and Evaluation).

Results: Of the 15 studies (20 arms; n = 757), 7 included healthy participants, while 8 involved non-healthy individuals, including 4 studies on prediabetes or diabetes. Pooled estimates indicated non-significant effects of carotenoid supplementation on all enzymes including ALT (WMD: -2.25 IU/L, 95%CI: -4.84,0.34, P = 0.089), AST (WMD: -0.46 IU/L, 95%CI: -1.25,0.34, P = 0.259), ALP (WMD: -0.34 IU/L, 95%CI: -6.89,6.21, P = 0.918) and GGT (WMD: -0.43 IU/L, 95%CI: -3.06,2.21, P = 0.751) levels non-significantly. Significant reductions in ALT levels occurred in < 12 weeks (P = 0.028), BMI ≥ 25 (P = 0.045), and among non-healthy participants (P = 0.015). AST levels were significantly reduced in non-healthy participants (P = 0.003) with ages > 50 (P = 0.003) as well as GGT levels (P = 0.011) in non-healthy participants.

Conclusion: Carotenoid supplementation might be beneficial in reducing liver enzymes, especially in non-healthy participants and in those with a BMI ≥ 25 kg/m². However, more trials with standard methods are required.

Prospero registeration code: CRD42024612956.

Background: Colectomy for colon cancer typically results in gastrointestinal hypomotility. Daikenchuto, a herbal medicine traditionally used in Japan, is administered to alleviate gastrointestinal hypomotility. However, it is suspected to cause hepatobiliary injury. Therefore, in this comparative, retrospective cohort study, we aimed to assess the risk of daikenchuto administration-induced hepatobiliary injury post-colectomy.

Methods: Patients with colon cancer who underwent colectomy, excluding the population with a high risk of postoperative hepatobiliary injury, were included in this study (N = 17,996). Specifically, patients who received daikenchuto within 4 days after colectomy or from the day of surgery to the first meal postoperatively and those who did not receive daikenchuto were assigned to the daikenchuto exposure and non-exposure groups, respectively. The primary outcome was the postoperative administration of cholagogues or hepatoprotective drugs. Multivariate logistic regression analysis was performed considering the perioperative risk factors for hepatobiliary injury. The analysis estimated the adjusted odds ratios to assess the risk of daikenchuto-induced hepatobiliary injury.

Results: The frequencies of the postoperative administration of cholagogues or hepatoprotective drugs were 52 of 2,324 patients (2.24%) and 421 of 15,672 (2.69%) in the daikenchuto exposure and non-exposure groups, respectively. Furthermore, the adjusted odds ratio and 95% confidence interval (0.62-1.12) were < 1 and included 1, respectively.

Conclusions: No association between daikenchuto and the risk of hepatobiliary injury was identified. Thus, our results imply that daikenchuto can be safely administered post-colectomy.

Trial registration: This study was registered in the Japan Registry of Clinical Trials (Trial ID: jRCT1031240102; https://jrct.mhlw.go.jp/en-latest-detail/jRCT1031240102 ) on May 22, 2024.

Background: Lumbosacral radiculopathy, characterized by lower back nerve root pain, is a leading cause of activity limitations and healthcare costs. Acupotomy is a combination of acupuncture and minimally invasive treatment that relieves soft-tissue adhesions, complementing the anti-inflammatory effect of epidural steroid injection (ESI). Although the combination of acupotomy and ESI has shown clinical evidence for pain management, economic evaluations remain scarce. To address this gap, we performed a cost-utility analysis comparing Acupotomy combined with ESI and ESI alone in patients with lumbosacral radiculopathy.

Methods: A randomized controlled trial enrolled patients aged 18-85 years with lumbosacral radiculopathy. Participants were randomized 1:1 to receive either Acupotomy with ESI or ESI single treatment. Utility values were measured using the EuroQol-5 Dimensions-5 Levels questionnaire, and quality-adjusted life year (QALY) were calculated. Direct (medical and non-medical) and indirect costs (productivity loss) were estimated from a societal perspective. The incremental cost-utility ratio was calculated to evaluate the cost-effectiveness of the interventions.

Results: Among 50 patients, the mean age was 62.0 years, and 58.0% were females. The overall costs, including direct and indirect costs, were $609 for the Acupotomy with ESI group and $757 for the ESI group. The incremental QALYs for the Acupotomy with ESI group compared to the ESI group were 0.01 QALYs, and the incremental costs were -$147. The incremental cost-utility ratio was -$16,314/QALY, indicating the dominance of combination therapy. Additionally, the average indirect costs for the Acupotomy with ESI and the ESI group were $243 and $498, respectively, representing lower indirect costs in combination therapy.

Conclusions: Acupotomy with ESI treatment was associated with short-term improvements in quality of life and lower total costs over 8 weeks, compared to ESI. These findings should be interpreted with caution, given the limited sample size, short follow-up period, and the restricted generalizability due to a single-center design and specific clinical setting. Nonetheless, this study provides preliminary evidence suggesting the potential cost-effectiveness of acupotomy with ESI for managing lumbosacral radiculopathy.

Trial registration: trial registration number, KCT0006158.

Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women and the most common cause of anovulatory infertility. It is considered incurable in conventional medicine and both patients and physicians have expressed dissatisfaction with delayed diagnosis, challenging and unsatisfactory management regimen used. Global interest in Complementary and alternative medicine (CAM) is rising, and patients have expressed a desire to find a safe and effective treatment for their PCOS.

Objective: The objective of this study was to determine the prevalence and factors associated with the use of complementary and alternative medicine among PCOS patients.

Methodology: A sample size of 209 was calculated; however, due to a response rate of 86%, a total of 180 questionnaires were analyzed. The study employed a universal sampling method. An analytic cross-sectional study was conducted on 180 patients with PCOS recruited from 2 hospitals. Validated self-administered questionnaire was used and data was analyzed using SPSS version 25.0. Independent variables included socio-demographic factors, perceived severity, benefits, and barriers. Binary logistic regression was used to analyze the relationship between CAM use and perceived severity, benefit, barriers, and health locus of control, while the chi-square test examined the link between socio-demographic factors and CAM use.

Results: A total of 180 patients with PCOS responded to the study. 67.2% of respondents were aged 30-39, with infertility being the most common symptom (85.2%). The prevalence of CAM use was 57.8%, and 12.8% of respondents reported side effects. Ethnicity (Malay) was significantly associated with CAM use (x² = 4.408, p = 0.036), and perceived benefit also showed a significant association (OR = 2.09, p = 0.007). However, perceived severity, perceived barrier, and health locus of control had no significant association with CAM use.

Conclusion: In conclusion, this study established the prevalence of complementary and alternative medicine (CAM) use among patients with polycystic ovary syndrome (PCOS) and highlighted key factors influencing their preference for such treatments. These findings provide valuable insights for healthcare providers and policymakers to better understand patient behavior and treatment choices, ultimately aiding in the development of more patient-centered, culturally sensitive, and effective management strategies for PCOS.

Background: Acute kidney injury (AKI) is a common and serious complication of cisplatin chemotherapy in cancer patients, with no effective treatment currently available. Oxidative stress and renal tubular damage are key contributors to its pathogenesis. This study aimed to investigate the antioxidant and renoprotective effects of black garlic water extract in a cisplatin-induced AKI mouse model.

Methods: Mice were randomly divided into six groups: Control, Cisplatin only (20 mg/kg), black garlic extract pretreatment at 50 or 100 mg/kg followed by cisplatin (Cis + B50, Cis + B100), amifostine pretreatment (200 mg/kg) as positive control (Cis + A200), and black garlic extract only (100 mg/kg). Black garlic extract was characterized for its sulfur compound content and antioxidant potential.

Results: Black garlic contained significantly higher levels of S-allyl-L-cysteine (191.2 ± 32.87 µg/g) than raw garlic (20.7 ± 0.8 µg/g) and effectively delayed low-density lipoprotein oxidation. Pretreatment with black garlic extract reduced cisplatin-induced weight loss, renal index elevation, and tubular damage. Antioxidant enzyme activities, including superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase, were significantly increased in the Cis + B100 and Cis + B50 groups.

Conclusions: Black garlic extract confers protection against cisplatin-induced AKI by enhancing renal antioxidant defenses and mitigating oxidative stress-related damage. These findings support its potential as a complementary approach for preventing nephrotoxicity during cisplatin therapy.

Background: Patients with end-stage renal disease (ESRD) who undergo long-term hemodialysis (HD) often suffer from fatigue and poor sleep quality. Although acupuncture is known to help regulate and enhance bodily functions, it remains uncertain whether laser acupuncture can benefit these patients. This double-blind, randomized, placebo-controlled trial aimed to evaluate the effects of laser acupuncture on reducing fatigue and improving sleep quality in hemodialysis patients. The study also considered time-varying dialysis and depressive symptoms.

Methods: Seventy-two patients were randomly assigned to either the laser acupuncture (LA) group or the control group. The LA group received acupuncture with a low-level laser at specific points: Hegu (LI4), Shenmen (HT7), Neiguan (PC6), Taixi (KI3), Zusanli (ST36), Yanglingquan (GB34), and Sanyinjiao (SP6). The control group received the same treatment without laser energy. Measurements were taken at baseline, Week 2, Week 4, and Week 6.

Results: Adjusted for HD and depression symptoms, the mixed linear model showed significant improvements in the LA group compared to the control group and baseline scores. Notable improvements were observed in fatigue visual analog scale scores, HD-related fatigue scale scores, recovery time after HD, and Pittsburgh sleep quality index at Week 2, Week 4, and Week 6 (p < 0.05).

Conclusions: A six-week laser acupuncture treatment significantly improved fatigue and sleep quality in patients with ESRD on HD, regardless of dialysis timing and depressive symptoms. The treatment is non-invasive, safe, and short, making it a promising option for the post-dialysis period. Future research should evaluate the long-term effects of laser acupuncture on patients with HD, and involving more medical centers could strengthen the significance of this study's results.

Implication for the profession and/or patient care: These findings provide valuable insights into the benefits of laser acupuncture for alleviating post-dialysis fatigue, shortening fatigue recovery time, and improving sleep quality in patients with ESRD undergoing HD. Starting in the second hour of the HD procedure, laser acupuncture can be applied to seven specific acupoints: LI4, HT7, PC6, KI3, ST36, GB34, and SP6. For the best results, it is recommended that laser acupuncture be performed for at least two weeks.

Trial registration: This clinical trial was registered in ClinicalTrials.gov with registration NCT06028685 (31/07/2023).