Li Dan , Zhang Guilin , Zhang Linxue , Tang Yao , Wang Li , Xu Ying , Cao Jinkui , Zhao Wenqian , Zuo Guanchao , Li Hang , Li Dehua
{"title":"Effect of thumbtack needle on functional constipation: A pragmatic randomized controlled trial","authors":"Li Dan , Zhang Guilin , Zhang Linxue , Tang Yao , Wang Li , Xu Ying , Cao Jinkui , Zhao Wenqian , Zuo Guanchao , Li Hang , Li Dehua","doi":"10.1016/j.ctim.2024.103069","DOIUrl":"10.1016/j.ctim.2024.103069","url":null,"abstract":"<div><h3>Objective</h3><p>Thumbtack Needling (TN) has been employed in the treatment of functional constipation (FC), although the existing evidence supporting its effectiveness is limited. This study is to evaluate the efficacy of TN in ameliorating FC.</p></div><div><h3>Method</h3><p>A total of 482 eligible patients were recruited and randomly assigned to the TN group or the Mosapride Citrate (MC) group. The TN was buried once for three days, rest for one day after two consecutive burials, followed by a 4-week follow-up. The primary outcome measure was the score for Complete and spontaneous bowel movement score (CSBMs). Secondary outcome measures included the Bristol Stool Form Scale (BSFS), Cleveland Clinic Score (CCS), and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL).</p></div><div><h3>Results</h3><p>Out of the 482 patients randomized, 241 were allocated to each group. Of these, 216 patients (89.6 %) in both groups completed the intervention and follow-up. Compared with the baseline, the differences of CSBMs in TN group [1.76(95 % CI, 1.61 to 1.91)] and MC group [1.35(95 % CI, 1.20 to 1.50)] at week 4 meet the threshold for minimal clinically important difference (MCID). However, there were no clinical difference from baseline at week 2 and week 8 in both groups. Mean CSBMs at week 4 was 3.35 ± 0.99 in the TN group and 3 ± 1.03 in the MC group (adjusted difference between groups, 0.37 points [95 % CI, 0.18 to 0.55]; <em>P</em> < 0.001), although differences between the two groups did not meet the MCID threshold.</p></div><div><h3>Conclusion</h3><p>Compared with mosapride citrate, thumbtack needling produced a greater improvement in CSBMs, although the difference from control was not clinically significant.</p></div><div><h3>ClinicalTrials.gov identifier</h3><p>ChiCTR2100043684</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103069"},"PeriodicalIF":3.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000578/pdfft?md5=9c6a4a24a6595bcb0be389096ac39479&pid=1-s2.0-S0965229924000578-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Consensus-based guideline for the supportive anthroposophic therapies to treat children with pseudocroup (stenosing laryngotracheitis)","authors":"Melanie Schwermer , Alfred Längler , Tycho Zuzak","doi":"10.1016/j.ctim.2024.103072","DOIUrl":"10.1016/j.ctim.2024.103072","url":null,"abstract":"<div><h3>Purpose</h3><p>Supportive anthroposophic therapies are used to treat children with pseudocroup by pediatricians in outpatient and inpatient settings. Anthroposophic treatment comprises forms of creative therapies, external applications as well as remedies, which production is based on the knowledge of the human being, nature and substances. A scientifically based guideline for these therapies is lacking. Due to insufficient study situation, we developed a consensus-based guideline to make therapy decisions more transparent and facilitate clinical routine.</p></div><div><h3>Methods</h3><p>An online Delphi process with 67 anthroposophic pediatricians was conducted. Recommendations were accepted when reaching more than 75 % of expert agreement; otherwise, recommendations were revised and assessed by the experts once again.</p></div><div><h3>Results</h3><p>Recommendations for general interventions and for anthroposophic remedies (Bryonia/Spongia comp.; Larynx/Apis comp.) as well as for external applications (embrocation with lavender oil) were developed. Recommendations have a consensus of 96.4 % or more.</p></div><div><h3>Conclusion</h3><p>The consensus-based guideline provides practical recommendations for the supportive anthroposophic therapies for pseudocroup. The implementation and practicability of this guideline has to be investigated.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103072"},"PeriodicalIF":3.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000608/pdfft?md5=2c1efba4f3b29e9da2194aef02c34969&pid=1-s2.0-S0965229924000608-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dong Li , Larissa Tao , Jia Yang, Wa Cai, Weidong Shen
{"title":"Global research trends in acupuncture treatment for post-stroke depression: A bibliometric analysis","authors":"Dong Li , Larissa Tao , Jia Yang, Wa Cai, Weidong Shen","doi":"10.1016/j.ctim.2024.103070","DOIUrl":"10.1016/j.ctim.2024.103070","url":null,"abstract":"<div><h3>Objective</h3><p>Post-stroke depression (PSD) is a prevalent and severe sequela of stroke. It is an emotional disorder that significantly impacts functional recovery, prognosis, secondary stroke risk, and mortality among stroke survivors. The incidence rate of PSD is 18 %∼33 %, with symptoms such as low mood, decreased interest, sleep disorders, decreased appetite, impaired attention, and in severe cases, hallucinations and even suicidal tendencies. While diverse therapeutic modalities are employed globally to address PSD, each approach carries its inherent advantages and limitations. Notably, acupuncture stands out as a promising and effective intervention for ameliorating PSD symptoms and enhancing stroke prognosis. This study aims to conduct a bibliometric analysis to scrutinize the current landscape, identify hotspots, and explore frontiers in acupuncture research for PSD.</p></div><div><h3>Methods</h3><p>A systematic search for acupuncture and PSD-related research was conducted from January 2014 to October 2023 on the Web of Science Core Collection (WoSCC). The data were downloaded and processed using Bibliometrix and VOSviewer to generate knowledge visualization maps.</p></div><div><h3>Results</h3><p>A total of 11,540 articles related to acupuncture and PSD were retrieved. China emerged as the leading contributor with the highest volume of articles on acupuncture and PSD. Author Liu CZ attained the highest H-index, focusing primarily on investigating the compatibility effects and mechanisms of acupoints. Common hotspot keywords included pain, stimulation, mechanisms, complementary, and alternative medicine. The main research frontiers were mechanisms, neuroinflammation, gut microbiota, and therapeutic methods.</p></div><div><h3>Conclusion</h3><p>This study offered multifaceted insights into acupuncture for PSD, unveiling pivotal areas, research hotspots, and emerging trends. The findings aimed to guide researchers in exploring novel research directions and selecting appropriate journals for advancing the understanding and treatment of PSD through acupuncture interventions.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103070"},"PeriodicalIF":3.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096522992400058X/pdfft?md5=f94a8efb25c0a11f624a11d8dd9cc27e&pid=1-s2.0-S096522992400058X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asma Kazemi , Sara Shojaei-Zarghani , Parham Eskandarzadeh , Mohammad Hashem Hashempur
{"title":"Effects of chamomile (Matricaria chamomilla L.) on sleep: A systematic review and meta-analysis of clinical trials","authors":"Asma Kazemi , Sara Shojaei-Zarghani , Parham Eskandarzadeh , Mohammad Hashem Hashempur","doi":"10.1016/j.ctim.2024.103071","DOIUrl":"10.1016/j.ctim.2024.103071","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to investigate the effects of chamomile (<em>Matricaria chamomilla</em> L.) on sleep in this systematic review and meta-analysis of clinical trials.</p></div><div><h3>Methods</h3><p>PubMed, Scopus, Web of Science, and Cochrane Library were searched until August 2023. All clinical trials that investigated the effects of chamomile on sleep, either in healthy or diseased adults, were eligible to enter the study. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool weighted mean differences (WMD) and 95 % CI for the outcomes assessed by at least three studies with relatively consistent participants.</p></div><div><h3>Results</h3><p>The systematic review included ten studies (772 participants). Meta-analysis was conducted for the Pittsburgh Sleep Quality Index (PSQI) score and sleep length. A significant reduction in PSQI score (WMD: −1.88, 95 %CI: −3.46, −0.31, I2: 88.4 %, n = 5) was found. For other outcomes, meta-analysis was not conducted. Sleep onset latency or ease of getting to sleep were improved in three of the four studies. Daytime functioning measures, including fatigue severity index or postpartum fatigue scale, did not change in all three studies. Sleep efficiency did not change in two studies and deteriorated in one. The number of awakenings after sleep or staying asleep was improved in two of the three studies. No adverse events were reported in any of the studies although passive surveillance was used to assess adverse effects except in one study. Only one study surveyed the blinding success and tested the purity and/or potency of the used products.</p></div><div><h3>Conclusion</h3><p>Chamomile improved sleep, especially the number of awakenings after sleep or staying asleep; however, it did not lead to an improvement in the duration of sleep, percentage of sleep efficiency, and daytime functioning measures. Future studies are suggested to assess objective measures.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103071"},"PeriodicalIF":3.3,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000591/pdfft?md5=1ed4e40c13059e1ce2cf88ef4589f85b&pid=1-s2.0-S0965229924000591-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roopa Nanjundaswamy , Narendra J. B , Vinu Vijayakumar , Srikanth N. Jois , K. Nagendra Prasad
{"title":"Effectiveness of Pranic Healing as complementary therapy on lower urinary tract symptoms and sleep: Single-blind randomized trial","authors":"Roopa Nanjundaswamy , Narendra J. B , Vinu Vijayakumar , Srikanth N. Jois , K. Nagendra Prasad","doi":"10.1016/j.ctim.2024.103067","DOIUrl":"10.1016/j.ctim.2024.103067","url":null,"abstract":"<div><h3>Background</h3><p>Benign Prostatic Hyperplasia (BPH) commonly affects older men, leading to lower urinary tract symptoms (LUTS) that affect sleep and quality of life. This study evaluates the effect of Pranic Healing (PH) as a complementary therapy for bothersome LUTS by normalising biofield energy centres called <em>Chakras</em>.</p></div><div><h3>Methodology</h3><p>A single blind trial involving 76 men with LUTS was conducted, randomised into Medication-only (MED) and Medication-plus-Pranic Healing (MEDPH) groups. The MEDPH received PH sessions twice weekly for 5 weeks.</p></div><div><h3>Results</h3><p>The study compared MED (n = 30) and MEDPH (n = 36) participants, finding significant improvements in IPSS scores (p ≤ .001) in both groups. The MEDPH group showed a greater reduction in incomplete bladder emptying and intermittency. The post void residual volume increased significantly in the MED group (Wilcoxon Z = −2.335, p = .02), while the MEDPH group reduced non-significantly. Sleep quality index improved significantly (McNemar=.013) in the MEDPH group, while the MED group showed no significant change. Subjective sleep quality, duration, and latency improved significantly in the MEDPH group. Healers reported improved energy balance in <em>chakras</em> of MEDPH group. Perceived energy by healers in lower <em>chakra</em> relates to urinary parameters.</p></div><div><h3>Conclusion</h3><p>PH could alleviate LUTS, enhancing quality of life due to urination, and improved sleep, among moderate BPH patients.</p></div><div><h3>Trial registration</h3><p>This study has been registered under the Clinical Trial Registry of India. (CTRI No: CTRI/2023/01/049004)</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103067"},"PeriodicalIF":3.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000554/pdfft?md5=ffc6a275d8c073e402c0c77fd9d70b04&pid=1-s2.0-S0965229924000554-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hui Xu , Zheng Wang , Zhen Wang , Yang Lei , Juntao Chen , Hang Zhou , Mengmeng Li , Jieyao Diao , Yanqin Bian , Bin Zhou , Yunfeng Zhou
{"title":"Recent trends in Tuina for chronic pain management: A bibliometric analysis and literature review","authors":"Hui Xu , Zheng Wang , Zhen Wang , Yang Lei , Juntao Chen , Hang Zhou , Mengmeng Li , Jieyao Diao , Yanqin Bian , Bin Zhou , Yunfeng Zhou","doi":"10.1016/j.ctim.2024.103068","DOIUrl":"https://doi.org/10.1016/j.ctim.2024.103068","url":null,"abstract":"<div><h3>Background</h3><p>The utilization of Tuina as a therapeutic intervention for the management of chronic pain has experienced a gradually increase in its popularity, and the purpose of this bibliometric analysis is to offer a comprehensive understanding of the current state and frontier trends, as well as to provide recommendations for future research directions.</p></div><div><h3>Methods</h3><p>Publications on Tuina for chronic pain published between 2004 and 2023 were retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel, CiteSpace, VOSViewer, and the R package “bibliometrix” were used to quantitatively analyse the annual publication volume, countries/regions, journals, institutions, cited references, authors, and keywords.</p></div><div><h3>Results</h3><p>A total of 287 publications were retrieved. The number of annual publications on the use of Tuina for treating chronic pain has gradually increased. Most publications were published in China and the United States. Notably, the most productive institution and author were identified as Shanghai University of Traditional Chinese Medicine and Min Fang, respectively. <em>Medicine</em> ranked first as the most influential affiliate and most productive journal. These publications came from 1650 authors, among whom Edzard Ernst had the most co-citations. Keyword analysis revealed that the new research frontier was low back pain.</p></div><div><h3>Conclusion</h3><p>The utilization of Tuina for the treatment of chronic pain has been gaining increasing recognition. Acupuncture, randomised controlled trials, systematic reviews, etc. were the main research subjects. Furthermore, low back pain is the new research frontier. This study provides an in-depth perspective on Tuina for chronic pain, which provides valuable reference material for clinicians with insights of therapeutic strategy, educators with valuable topics, and researchers with new research directions.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103068"},"PeriodicalIF":3.3,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000566/pdfft?md5=b8cc264f88cf5e6ec5bd5f017634fa56&pid=1-s2.0-S0965229924000566-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141606499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effects of flaxseed (Linum usitatissimum) supplementation on anthropometric indices: An updated systematic review and meta-analysis of randomized clinical trials","authors":"","doi":"10.1016/j.ctim.2024.103066","DOIUrl":"10.1016/j.ctim.2024.103066","url":null,"abstract":"<div><h3>Objective</h3><p>Flaxseed (<em>Linum usitatissimum</em>) supplementation has shown promise as an anti-obesity agent in various clinical trials, although results have been inconsistent. To provide a more accurate assessment of the impact of flaxseed supplementation on anthropometric indices, a systematic review and meta-analysis was performed.</p></div><div><h3>Methods</h3><p>We searched several international databases until August 2023, including Scopus, PubMed, Web of Science, Embase, and Cochrane Library. Weighted mean differences (WMDs) were analyzed using a random-effects model.</p></div><div><h3>Results</h3><p>Sixty-four trials comprising 72 treatment arms were included. All studies reported the intervention types (Lignans, Whole flaxseed, and Flaxseed oil) and dosage. However, three studies did testing for purity, and 40 studies reported potency. Also, the risk of contamination with heavy metals was not mentioned in studies. Another limitation was the lack of blind evaluation in the studies. According to three trials included in the systematic review, flaxseed did not affect anthropometric indices. Our meta-analysis revealed significant reductions in body weight (WMD = −0.63 kg; 95 % CI: −1.00, −0.27, P < 0.001; I<sup>2</sup> = 76.7 %, P < 0.001), body mass index (BMI) (WMD: −0.24 kg/m2, 95 % CI: −0.36, −0.11, P < 0.001; I<sup>2</sup> = 78.5 %, P < 0.001) and waist circumference (WC) (WMD: −1.43 cm, 95 % CI: −2.06, −0.80, P < 0.001; I<sup>2</sup> = 81.1 %, P < 0.001) following flaxseed supplementation. Subgroup analyses indicated that interventions lasting 10–20 weeks, and studies involving subjects with higher BMI (>30 kg/m<sup>2</sup>) showed more significant anti-obesity effects. Based on the GRADE evaluation, body weight, BMI, and WC results were considered as moderate-certainty evidence.</p></div><div><h3>Conclusion</h3><p>Our systematic review and meta-analysis suggests that supplementation with flaxseed <em>(Linum usitatissimum</em>) leads to meaningful improvements in body weight, BMI, and WC. Therefore, flaxseed can be considered as an adjunctive therapeutic approach in improving obesity</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103066"},"PeriodicalIF":3.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000542/pdfft?md5=478ec8d9c392acdc9fbc30e78ecfa739&pid=1-s2.0-S0965229924000542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evidence mapping and quality assessment of systematic reviews on exercise intervention for Alzheimer’s disease","authors":"Zhengdong Xu , Jiaxing Tang , Wenjuan Yi","doi":"10.1016/j.ctim.2024.103065","DOIUrl":"10.1016/j.ctim.2024.103065","url":null,"abstract":"<div><h3>Background</h3><p>A significant body of literature suggests that exercise can reverse cognitive impairment and ameliorate somatic function in patients with Alzheimer's disease (AD). Systematic reviews (SRs), a common approach of evidence-based medicine, concentrate on a specific issue of a research area. The objective of this work is to provide an overview of existing evidence on the effects of exercise intervention in AD patients and report related health outcomes by reviewing SRs.</p></div><div><h3>Methods</h3><p>SRs on exercise intervention in AD patients were retrieved from the PubMed, the Cochrane Library, CBMdisc, Scopus, Web of Science, Embase (via Ovid), China National Knowledge Infrastructure, and WanFang databases from the time of inception to February 2023. The quality of the SRs was evaluated utilizing the A Measurement Tool to Assess Systematic Review 2 (AMSTAR 2) checklist. The results were reported according to the population-intervention-comparison-outcome (PICO) framework and the corresponding evidence mapping was illustrated in tables and bubble plots.</p></div><div><h3>Results</h3><p>A total of 26 SRs met the eligibility criteria. In terms of methodological quality, 10 SRs were rated as \"critically low\", 13 SRs were rated as \"low\", and 3 SRs were rated as \"moderate\". Exercise was found to exert a beneficial effect on cognitive function, functional independence, physical function, and neuropsychiatric symptoms in patients with AD.</p></div><div><h3>Conclusion</h3><p>Exercise intervention benefits AD patients mainly by improving cognitive function, physical function, functional independence, and neuropsychiatric symptoms. However, due to the low-to-moderate methodology of most SRs included in this analysis, further investigations are required to support our current findings.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103065"},"PeriodicalIF":3.3,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000530/pdfft?md5=6b19dab5c6999ffd0847c0b851782207&pid=1-s2.0-S0965229924000530-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of dark chocolate/ cocoa consumption on oxidative stress and inflammation in adults: A GRADE-assessed systematic review and dose-response meta-analysis of controlled trials","authors":"Mehrdad Behzadi , Mohammad Vesal Bideshki , Maryam Ahmadi-Khorram , Meysam Zarezadeh , Alireza Hatami","doi":"10.1016/j.ctim.2024.103061","DOIUrl":"10.1016/j.ctim.2024.103061","url":null,"abstract":"<div><h3>Background</h3><p>Oxidative stress and inflammation play critical roles in the pathogenesis of many chronic diseases. Dark chocolate (DC)/cocoa, as a rich source of polyphenols like flavonoids, has anti-inflammatory and antioxidant properties that may confer health benefits, but findings in this context are inconsistent.</p></div><div><h3>Objective</h3><p>This systematic review and dose-response meta-analysis aimed to provide a comprehensive overview of the controlled trials (CTs) that have examined the effects of DC/cocoa on oxidative stress and inflammation biomarkers in adults.</p></div><div><h3>Search methods</h3><p>Databases including PubMed, Web of Science, and Scopus, were searched for relevant studies through April 2024.</p></div><div><h3>selection criteria</h3><p>Studies assessed C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), P-selectin, E-selectin and thiobarbituric acid reactive substances (TBARS) in adults were included.</p></div><div><h3>Data analysis</h3><p>Based on the random-effects model, we calculated WMDs, SMDs and 95 % confidence intervals (CIs). Sensitivity, sub-group, meta-regression and dose-response analyses were also conducted.</p></div><div><h3>Results</h3><p>Thirty-three eligible CTs with 1379 participants were included. All studies reported the intervention types (cocoa powder, beverages and chocolate bars) and dosage. However, sixteen studies didn’t do/report testing for purity and potency by independent groups. Also, none of the studies mentioned the risk of contamination with heavy metals. Another limitation was the lack of blinding assessment in studies. DC/cocoa significantly reduced MDA (SMD: −0.69, 95 %CI: −1.17, −0.2, p = 0.005) and increased NO levels (SMD: 2.43, 95 %CI: 1.11,3.75, p < 0.001); However, it has no significant effects on the other outcomes. Greater anti-inflammatory effects occurred at higher flavonoid doses (>450 mg/day) and for shorter durations (≤4 weeks) in the non-healthy participants. Non-linear dose-response relationships between cocoa dosage and CRP level and also between flavonoid dosage and IL-6 level were observed. Based on the GRADE evaluation, just CRP and MDA results were considered as high certainty evidence and the other outcomes results were categorized as very low to moderate certainty.</p></div><div><h3>Conclusions</h3><p>DC/cocoa may improve systemic oxidative status and inflammation in adults. However, further studies should be performed to determine its benefits.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103061"},"PeriodicalIF":3.3,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000499/pdfft?md5=952b37a0f4c496bc52cc0162d035ba0a&pid=1-s2.0-S0965229924000499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical effects of Hibiscus sabdariffa Linn. on obesity treatment: A systematic review and meta-analysis of randomized controlled trials","authors":"Piyameth Dilokthornsakul , Natnicha Rattanachaisit , Phiyanuch Thimkorn , Supawan Pongpattanawut , Witoo Dilokthornsakul , Teerapon Dhippayom","doi":"10.1016/j.ctim.2024.103063","DOIUrl":"10.1016/j.ctim.2024.103063","url":null,"abstract":"<div><h3>Introduction</h3><p>Obesity is associated with many chronic non-communicable diseases, including hypertension, diabetes, cardiovascular and cerebrovascular diseases, cancer, gallbladder disease, bone and joint disorders, skin diseases, fatty liver disease, etc. (Wharton et al., 2020)<sup>1</sup> The recent report revealed that overweight and obesity were prevalent in 60 % of the adult population. Several studies have been published to determine the effect of <em>Hibiscus sabdariffa</em> Linn. on obesity treatment, but the findings are still inconclusive. The purpose of this study was to determine the efficacy and safety of <em>H. sabdariffa</em> Linn in the treatment of obesity.</p></div><div><h3>Methods</h3><p>We searched PubMed, EMBASE, and CENTRAL from inception to February 2024. Randomized controlled trials (RCTs) were included if they explored the effect of <em>H. sabdariffa</em> on one of the following outcomes: body weight, body mass index (BMI), waist circumference, and waist-to-hip ratio. A random-effects model was used to meta-analyze the data. <em>I</em><sup><em>2</em></sup> was used to quantify statistical heterogeneity among the included RCTs. PROSPERO registered protocol: CRD42023408880.</p></div><div><h3>Results</h3><p>A total of six RCTs with 339 participants were included. Four trials used <em>H. sabdariffa</em> extract in capsules as the intervention of interest compared to placebo, while the other two trials used <em>H. sabdariffa</em> tea compared to black or green tea. Our meta-analyses showed that the mean difference in weight reduction between <em>H. sabdariffa</em> and control was − 0.27 kg (95 % confidence interval (CI); − 1.98 to 1.42, <em>I</em><sup><em>2</em></sup> = 0.0 %). The mean differences for BMI and waist circumference reduction were − 0.06 kg/m<sup>2</sup> (95 % CI; − 0.58 to 0.47, <em>I</em><sup><em>2</em></sup> = 0.0 %) and − 0.20 centimeters (95 % CI; − 2.06 to 1.66, <em>I</em><sup><em>2</em></sup> = 0.00 %). No safety concerns were reported in the included studies.</p></div><div><h3>Conclusion</h3><p>Our study did not show a clinical benefit of <em>H. sabdariffa</em> extract in obesity treatment. However, further high-quality RCTs with a longer treatment duration and a standard dose are still warranted.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"84 ","pages":"Article 103063"},"PeriodicalIF":3.3,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000517/pdfft?md5=1c843e4f77d265f518af87584423c6ba&pid=1-s2.0-S0965229924000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}