Complementary therapies in medicine最新文献

{"title":"Introducing a novel sham acupuncture method for double-blind trials: A validation study","authors":"Sung Min Lim ,&nbsp;Eunji Go ,&nbsp;Jungsup Lee ,&nbsp;Go Eun Lee ,&nbsp;Chihyoung Son","doi":"10.1016/j.ctim.2025.103198","DOIUrl":"10.1016/j.ctim.2025.103198","url":null,"abstract":"<div><h3>Introduction</h3><div>Various clinical studies have been conducted worldwide to evaluate the effectiveness of acupuncture; however, designing an adequate control group is challenging. Sham acupuncture tools, designed to mimic real acupuncture without skin penetration, aim to address this challenge, but their efficacy and blinding success are debated.</div></div><div><h3>Methods</h3><div>In this study, we conducted a randomized, double-blind, parallel-group clinical trial to validate a newly developed sham acupuncture method for future double-blind trials. Sixty-six healthy participants were randomly assigned to verum or sham acupuncture groups. Verum acupuncture targeted LI4 and ST36, common acupuncture points, while sham acupuncture aimed to mimic verum without skin penetration to ensure participant blinding. Blinding (Bang’s Blinding Index), penetration, pain, and <em>deqi</em> sensations were evaluated using a standardized questionnaire and an 11-point Numeric Rating Scale.</div></div><div><h3>Results</h3><div>Participant blinding was successfully maintained at ST36, whereas “more correct guesses” were observed for verum acupuncture than expected by chance for sham acupuncture at LI4. Furthermore, the practitioners randomly guessed the verum and sham acupuncture that they had administered to both points. Penetration and pain were higher in the verum group for both points, while <em>deqi</em> sensations had mixed responses. There were no adverse events in the verum acupuncture and sham acupuncture groups.</div></div><div><h3>Conclusions</h3><div>The newly developed sham acupuncture demonstrated potential in blinding participants and practitioners, particularly at ST36. However, challenges were observed, especially at LI4, indicating limitations in blinding efficacy. This study underscores the importance of additional validation studies with larger sample sizes, diverse acupuncture points, and specific patient populations.</div></div><div><h3>Trial registration</h3><div>Clinical Research Information Service of the Republic of Korea (registration number: KCT0008335, <span><span>https://cris.nih.go.kr</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103198"},"PeriodicalIF":3.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L-ornithine supplementation in periodontitis treatment yields greater benefits than L-arginine after one year: Part II of a randomized controlled pilot study","authors":"Viktoriya I. Shynkevych ,&nbsp;Svitlana V. Kolomiiets ,&nbsp;Kristina O. Udaltsova ,&nbsp;Igor P. Kaidashev","doi":"10.1016/j.ctim.2025.103202","DOIUrl":"10.1016/j.ctim.2025.103202","url":null,"abstract":"<div><h3>Background</h3><div>L-arginine and L-ornithine have previously shown limited short-term immunological benefits in the treatment of periodontitis. <strong>The aim</strong> of this study was to assess the extended efficacy and durability of the response to L-arginine or L-ornithine as adjuncts to periodontal therapy in adults with periodontitis.</div></div><div><h3>Materials and methods</h3><div>In this study, 75 patients who previously received the course of L-arginine or <span>L</span>-ornithine as adjuncts to professional mechanical plaque removal (PMPR) during a preliminary randomized short-term part of a clinical trial (NCT05042024) were assessed clinically and immunologically (nested) after 12 months follow-up. The immunological assay included immunohistochemical identification of densities of CD68 + and CD163 + single-positive gingival macrophages. All patients did not receive new prescriptions or dietary changes and underwent personalized steps of periodontal treatment during observation.</div></div><div><h3>Results</h3><div>After one year, patients who received L-arginine or <span>L</span>-ornithine exhibited a significant reduction of sites with periodontal pocket depth of 4–5 mm compared to PMPR (p &lt; 0.0001). L-ornithine was associated with BoP decreasing compared to PMPR and L-arginine (95 % CI of odds ratio [1.12–1.46], p = 0.0002; CI [0.72–0.94], p = 0.004), CD68 + and CD163 + macrophages density increasing compared to PMPR (p &lt; 0.001) and L-arginine (p &lt; 0.05). L-arginine resulted in increased density of CD68 + macrophages and elevated CD68 + /CD163 + ratio compared to the PMPR and L-ornithine; CI [0.41–0.63], p = 0.009, CI [1.45–2.72], p &lt; 0.0001.</div></div><div><h3>Conclusion</h3><div>After one year, L-ornithine supplementation demonstrated more pronounced clinical benefits than L-arginine, although both can modulate gingival CD68 + and CD163 + macrophages.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103202"},"PeriodicalIF":3.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the reporting of reflexology intervention studies","authors":"Jacqueline James ,&nbsp;Joseph T. Costello,&nbsp;Amy K. Drahota","doi":"10.1016/j.ctim.2025.103204","DOIUrl":"10.1016/j.ctim.2025.103204","url":null,"abstract":"","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103204"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effect of focused-extracorporeal shockwave therapy on muscular and adjacent tissue stiffness and pain changes in myofascial pain syndrome: A randomized controlled trial study","authors":"Pijakkana Vasvit ,&nbsp;Kultida Klarod ,&nbsp;Oranat Sukkho ,&nbsp;Sirirat Kiatkulanusorn ,&nbsp;Phurichaya Werasirirat ,&nbsp;Xue-Qiang Wang ,&nbsp;Yong-Hui Zhang ,&nbsp;Juntip Namsawang ,&nbsp;Pornpimol Muanjai ,&nbsp;Nongnuch Luangpon","doi":"10.1016/j.ctim.2025.103203","DOIUrl":"10.1016/j.ctim.2025.103203","url":null,"abstract":"<div><h3>Background</h3><div>Focused-extracorporeal shockwave therapy (fESWT) has recently been applied in the management of chronic pain. However, its effectiveness in reducing muscular stiffness and pain among office workers has not been extensively studied. This study aimed to investigate the effectiveness of fESWT and sham-fESWT in alleviating muscular stiffness, pain, and functional disability.</div></div><div><h3>Methods</h3><div>Sixty-four office workers (mean age 31.4 ± 9.5 years) with myofascial pain syndrome of the upper trapezius were randomly and equally assigned to receive either the fESWT or sham-fESWT. The interventions were administered once a week for 4 weeks, with 4 Hz frequency and a total energy of 0.1<img>0.232 mJ/mm². Measurements were recorded at baseline, immediately after treatment, at two weeks, and at four weeks, assessing shear modulus (tissue stiffness), visual analogue scale (VAS), and the neck disability index (NDI).</div></div><div><h3>Results</h3><div>The result demonstrated a significant acute decrease in shear modulus at the trigger point (<img>6.1 kPa, p = 0.009) and a delayed reduction in muscle stiffness of the lower aponeurosis (<img>5.3 kPa, p = 0.004) following 4 weeks. Additionally, VAS scores decreased at all time points following fESWT (p &lt; 0.05), while the sham-fESWT group also demonstrated reductions during the final two weeks. NDI showed a decrease in both groups after four sessions (p &lt; 0.05), with no group effect.</div></div><div><h3>Conclusion</h3><div>fESWT was effective in reducing muscular pain, stiffness, and functional disability in patients. However, the potential psychological effects of sham-fESWT on VAS and function should be considered. Further research is necessary to determine the optimal treatment sessions and intensity of fESWT to better establish its efficacy.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103203"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effect of acupuncture on post-stroke dysphagia: A multicenter, randomized controlled trial","authors":"Shiqiang Zhang ,&nbsp;Biying Liang ,&nbsp;Qiang Tang ,&nbsp;Weibin Gao ,&nbsp;Hongyu Li ,&nbsp;Minmin Wu ,&nbsp;Xue Wang ,&nbsp;Luwen Zhu","doi":"10.1016/j.ctim.2025.103200","DOIUrl":"10.1016/j.ctim.2025.103200","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia is a common complication of stroke, significantly affecting patient prognosis and quality of life. Acupuncture is commonly used for treating post-stroke dysphagia in China, often combined with traditional swallowing rehabilitation training. However, the therapeutic effect of acupuncture alone on post-stroke dysphagia remains unclear.</div></div><div><h3>Objective</h3><div>To compare the clinical efficacy of acupuncture and traditional swallowing rehabilitation training in patients with post-stroke dysphagia.</div></div><div><h3>Method</h3><div>A multicenter, evaluator-blind, randomized controlled trial was conducted to recruit participants with post-stroke dysphagia. The experimental group received acupuncture treatment, whereas the control group received traditional swallowing rehabilitation training for 2 weeks. The Standardized Swallowing Assessment score and modified Barthel Index were compared between groups 1 and 2 weeks after the intervention. Surface electromyography (sEMG) was used to quantitatively evaluate the electromyographic activity in the suprahyoid and infrahyoid hyoid muscle groups.</div></div><div><h3>Result</h3><div>Overall, 254 participants were included. After 1 week of intervention, there was no significant between-group difference in efficacy (<em>p</em> &gt; 0.05). After 2 weeks of intervention, the Standardized Swallowing Assessment score of the experimental group showed a greater decrease (-1.56, 95 %CI [-2.83, −0.29], <em>p</em> &lt; 0.05). There was no significant between-group difference in the modified Barthel Index (2.00, 95 %CI [-2.00, 6.00], <em>p</em> &gt; 0.05). sEMG analysis showed that after 2 weeks of intervention, participants in the experimental group experienced greater increase in the root mean square value of the suprahyoid muscle group during fluid swallowing (1.02, 95 %CI [0.11, 2.27], <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Acupuncture may improve the swallowing function in patients with post-stroke dysphagia, offering therapeutic advantages for patients with pharyngeal phase dysphagia.</div></div><div><h3>Registration</h3><div>This study registered with the ClinicalTrials.gov Identifier: ChiCTR2000030994.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103200"},"PeriodicalIF":3.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tai Chi as a mind-body exercise modulates endothelial function in coronary artery disease: A randomized clinical trial","authors":"Yameng Li ,&nbsp;Cuihan Li ,&nbsp;Jiansheng Wen ,&nbsp;Meize Cui ,&nbsp;Qiuyang Wei ,&nbsp;Mingyu Liu ,&nbsp;Zaihao Chen ,&nbsp;Hui Fang ,&nbsp;Linli Liu ,&nbsp;Jiahao Fu ,&nbsp;Jianwei Zhang ,&nbsp;Shaojun Lyu","doi":"10.1016/j.ctim.2025.103201","DOIUrl":"10.1016/j.ctim.2025.103201","url":null,"abstract":"<div><h3>Objectives</h3><div>Tai Chi (TC), a mind-body aerobic exercise, has emerged as a potential alternative therapeutic modality for patients with coronary artery disease (CAD). Endothelial function is an important prognostic indicator in CAD. However, the effects of TC on endothelial function in CAD patients compared to aerobic exercise (AE) remain understudied.</div></div><div><h3>Design</h3><div>A parallel-group, assessor-blinded, randomized clinical trial (RCT).</div></div><div><h3>Setting</h3><div>Wanjie Rehabilitation Hospital and Anzhen Community Health Service Centre.</div></div><div><h3>Participants</h3><div>The present study enrolled 48 patients diagnosed with coronary artery disease (CAD), of whom 37 completed the 12-week intervention, 17 in the Tai Chi (TC) group and 20 in the aerobic exercise (AE) group.</div></div><div><h3>Interventions</h3><div>Both groups received supervised training three times a week at 40–60 % heart rate reserve (HRR), an intensity corresponding to the ventilatory anaerobic threshold (VO₂AT). Each 60–75-minute session consisted of four phases: 10–15 min of warm-up, 20–30 min of moderate-intensity Tai Chi’s Bafa Wubu (Eight Methods and Five Steps) or structured aerobic exercise (AE), 10–15 min of moderate-intensity Tai Chi elastic band exercises or resistance training, and 10–15 min of cool-down.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was endothelial function, assessed by biomarkers including nitric oxide (NO), endothelin (ET), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1). Secondary outcomes included lipid profiles measured by high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL).</div></div><div><h3>Results</h3><div>Baseline characteristics were not significantly different between groups (P &gt; 0.05). After 12 weeks, both TC and AE groups showed significant improvements in endothelial function: NO levels increased, while ET, VCAM-1, and ICAM-1 decreased (<em>P</em> &lt; 0.05). HDL levels increased only in the AE group (<em>P</em> &lt; 0.05). TC, TG, and LDL remained unchanged in both groups (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Tai Chi, as a mind-body exercise, may improve endothelial function in patients with CAD, even when serum lipid levels remain unchanged, providing benefits comparable to those of aerobic exercise (AE) despite different effects on high-density lipoprotein (HDL).</div><div>This trial has been registered on ClinicalTrials.gov (registration number: NCT03936504).</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103201"},"PeriodicalIF":3.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the effects of Western music and five-element music therapy on patients undergoing maintenance hemodialysis: A randomized controlled trial","authors":"Jingyi Zhang ,&nbsp;Liping Zhang ,&nbsp;Yifang Qiu ,&nbsp;Wenmin Wu ,&nbsp;Sujin Zhou ,&nbsp;Xuanying Ye ,&nbsp;Huiping Zeng ,&nbsp;Yun Gao","doi":"10.1016/j.ctim.2025.103199","DOIUrl":"10.1016/j.ctim.2025.103199","url":null,"abstract":"<div><h3>Background</h3><div>Due to the intricate interplay between music and culture, the comparative effectiveness of Western music therapy and five-element music therapy for Chinese patients undergoing maintenance hemodialysis warrants further investigation.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 87 patients receiving maintenance hemodialysis were recruited and randomly assigned to the five-element music group (n = 29), Western music group (n = 29), and control group (n = 29) in a 1:1:1 ratio. Participants in the five-element music group and Western music group received eight weeks of five-element music therapy and Western music therapy, respectively, for 60 min per session, three times per week. The primary outcome indicator was the Hospital Anxiety and Depression Scale score. The secondary outcome indicators were the Pittsburgh Sleep Quality Index, Dialysis Symptom Index, and Positive and Negative Emotions Scale scores. All outcome indicators were measured at baseline, on the day of the end of week 4 of the intervention, on the day of the end of week 8 of the intervention, and at the one-month follow-up after the end of the intervention.</div></div><div><h3>Results</h3><div>The results of the generalized estimating equations indicated that both five-element music therapy and Western music therapy were effective in alleviating anxiety, depression, sleep disturbances, and both positive and negative emotions among patients undergoing maintenance hemodialysis. However, patients in the five-element music group showed significantly greater relief from anxiety (mean difference = −1.76 ± 0.672, 95 % CI: 3.37, −0.15, <em>p</em> = 0.027), depression (mean difference = −1.79 ± 0.647, 95 % CI: −3.34, −0.24, <em>p</em> = 0.017), and both positive (mean difference = −3.00 ± 1.062, 95 % CI: 0.46, 5.54, <em>p</em> = 0.014) and negative emotions (mean difference = −3.38 ± 1.084, 95 % CI: −5.97, −0.78, <em>p</em> = 0.005) compared to those in the Western music group. Conversely, no significant differences were observed in sleep quality (mean difference = −1.07 ± 0.776, 95 % CI: −2.93, 0.79, <em>p</em> = 0.505) or symptom-related distress (mean difference = 3.62 ± 3.124, 95 % CI: −3.86, 11.10, <em>p</em> = 0.739) between the five-element music and Western music groups.</div></div><div><h3>Conclusion</h3><div>The significant benefits of five-element music therapy in improving emotions in Chinese patients undergoing maintenance hemodialysis highlight the importance of culturally tailored interventions.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103199"},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Honey for managing oral mucositis induced by cancer therapies: An overview of systematic reviews","authors":"Huda Anshasi ,&nbsp;Bassema Abufarsakh ,&nbsp;Ja’far M. Alkhawaldeh ,&nbsp;Sura Al Halalmeh","doi":"10.1016/j.ctim.2025.103197","DOIUrl":"10.1016/j.ctim.2025.103197","url":null,"abstract":"<div><h3>Purpose</h3><div>To synthesize and evaluate the quality of systematic reviews focusing on the use of honey for both the prevention and treatment of oral mucositis induced by cancer therapies.</div></div><div><h3>Methods</h3><div>An overview of systematic reviews was conducted by searching five electronic databases from inception to January 2024 to identify relevant studies evaluating the effectiveness of honey in the prevention and treatment of cancer therapy-induced oral mucositis.</div></div><div><h3>Results</h3><div>Twelve reviews were included, with seven (58.3 %) published after 2018. Five systematic reviews, four of which were rated as high quality, consistently found that honey significantly reduces the occurrence of severe radiation-induced oral mucositis (grades III and IV). Honey may also help alleviate severe pain requiring analgesics and reduce treatment interruptions, particularly among adult patients undergoing radiotherapy. However, findings regarding honey’s effectiveness in reducing the overall incidence of radiation-induced oral mucositis, regardless of severity, were inconsistent. These discrepancies are likely due to variations in patient populations, honey formulations, and timing or duration of administration. Evidence regarding honey's efficacy in chemotherapy- and chemoradiotherapy-induced mucositis remains inconclusive due to methodological limitations, clinical heterogeneity, and a limited number of high-quality studies.</div></div><div><h3>Conclusion</h3><div>Honey may be beneficial in reducing the incidence of severe oral mucositis (grades III and IV), relieving pain, and minimizing treatment disruptions in adult patients undergoing radiotherapy. However, its effectiveness across all grades and treatment modalities remains uncertain due to inconsistent findings, clinical heterogeneity, and methodological limitations. Further high-quality studies are needed to standardize honey types and dosing regimens and to stratify outcomes by mucositis grade, patient age, and cancer therapy type.</div></div><div><h3>Study Registration</h3><div>PROSPERO Protocol registration ID: CRD42024532801</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103197"},"PeriodicalIF":3.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of long-term exercise-based interventions on thyroid function in hypothyroidism: A systematic review and meta-analysis of randomized controlled trials","authors":"Habiba Sundus ,&nbsp;Sohrab Ahmad Khan ,&nbsp;Sahar Zaidi ,&nbsp;Charu Chhabra ,&nbsp;Irshad Ahmad ,&nbsp;Hiba Khan","doi":"10.1016/j.ctim.2025.103196","DOIUrl":"10.1016/j.ctim.2025.103196","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the effects of exercise interventions of more than 8 weeks on thyroid function in adults with hypothyroidism through a systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Materials and methods</h3><div>The PEDro, WOS, PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched for relevant articles, which then underwent standardised screening, data extraction, and bias risk assessment. A total of seven randomised controlled trials (n = 7) were included, predominantly examining 12 weeks of exercise therapy. A meta-analysis was conducted using data extracted from the included studies. Standardised mean differences were calculated for thyroid-stimulating hormone levels, and heterogeneity was assessed using the I² statistic. The certainty of evidence was evaluated using the GRADE approach.</div></div><div><h3>Results</h3><div>Statistically significant reductions in thyroid stimulating hormone (TSH) levels (SMD: −3.254; 95 % CI: −3.937 to −2.572; p &lt; 0.001) and increases in thyroxine (T4) level (SMD: 1.315; 95 % CI: 0.263–2.367; p = 0.015) were noted in exercise intervention groups as compared to control groups. Heterogeneity was moderate (I² = 65.93 %, p = 0.019) and no publication bias was detected. In addition, based on GRADE assessment, the certainty of evidence was rated as moderate for the TSH outcome and very low for the T4 outcome.</div></div><div><h3>Conclusion</h3><div>Findings from seven randomised controlled trials support the integration of long-term exercise as a non-pharmacological adjunct in the management of hypothyroidism. Exercise interventions, alongside conventional treatment, appear to improve thyroid function by reducing TSH and increasing T4 levels.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103196"},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of moxibustion on the pressure pain threshold and substance P / leukotriene B4 contents in serum to patients with rheumatoid arthritis","authors":"Siyu Tao ,&nbsp;Yi Yang ,&nbsp;Jie Tang ,&nbsp;Xue Wang ,&nbsp;Nannan Jiang ,&nbsp;Yuan Li ,&nbsp;Ping Wu","doi":"10.1016/j.ctim.2025.103187","DOIUrl":"10.1016/j.ctim.2025.103187","url":null,"abstract":"<div><h3>Objective</h3><div>To observe the effects of moxibustion on pressure-pain thresholds (PPTs) in affected joints and non-joint areas, as well as the contents of substance P (SP) and leukotriene B4 (LTB4) in serum of patients with rheumatoid arthritis (RA), and to explore the analgesic mechanism of moxibustion in RA patients.</div></div><div><h3>Methods</h3><div>A total of 72 patients with RA were randomly and equally classified into the control and treatment groups. The control group was treated with routine drug therapy, while the treatment group received routine drug therapy and moxibustion. Both groups were treated for 8 weeks. The symptoms, measured by PPTs, Visual analogue scale (VAS), pain joint count (PJC), swollen joint count (SJC) and disease activity score of 28 joints (DAS28), and laboratory indicators, measured by the level of SP, LTB4, tumor necrosis factor- α (TNF-α) and interleukin-1β (IL-1β), were compared in the two groups before and after intervention.</div></div><div><h3>Results</h3><div>A total of 66 patients completed the trial, with 1 patients dropping out from the treatment group and 5 patients being excluded and dropped from the control group. Trial endpoints were change (<em>∆</em>) in symptoms and laboratory indicators. The treatment group showed superior in <em>∆</em>PPTs of the interphalangeal joints(1301.71 (95 %CI, 967.43–1636.00) vs 443.23(95 %CI, 99.51–786.95)), <em>∆</em>SP(10.11 (95 %CI, 5.85–14.37) vs 3.10 (95 %CI, −1.13–7.34)), <em>∆</em> LTB4(13.17 (95 %CI, 7.81–18.54) vs 3.37 (95 %CI, −5.73–12.48)), <em>∆</em>TNF-α(4.57 (95 %CI, 2.60–6.55) vs 0.68 (95 %CI, −1.03–2.40)), <em>∆</em>IL-1β(4.63 (95 %CI, 2.59–6.66) vs 1.63 (95 %CI, −0.53–3.80)), <em>∆</em>PJC(7.14 (95 %CI, 5.17–8.58) vs 1.84 (95 %CI, 0.66–3.02)), <em>∆</em>SJC(5.20 (95 %CI, 3.44–6.96) vs 1.00(95 %CI, 0.02–1.98)), <em>∆</em>VAS(3.6 (95 %CI, 2.99–4.21) vs 0.9 (95 %CI, 0.24–1.57)), and <em>∆</em>DAS(1.68 (95 %CI, 1.44–1.92) vs 0.41 (95 %CI, 0.08–0.73)) compared to the control group, at weeks 4. Furthermore, there was a significant negative correlation between <em>∆</em>PPTs of the interphalangeal joints and <em>∆</em>SP in the treatment group (r &lt; 0, P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Moxibustion combined with conventional western medicine can significantly improve PPTs in affected joints of RA patients, alleviate clinical symptoms, and reduce disease activity. The potential mechanism may be related to the down-regulation of SP and LTB4 levels and the reduction of the release of inflammatory factors Il-1β and TNF-α by moxibustion. The lack of double-blinding is a limitation of our study, which we plan to avoid by establishing a sham moxibustion group in the subsequent trials.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"92 ","pages":"Article 103187"},"PeriodicalIF":3.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}