Complementary therapies in medicine最新文献

{"title":"Is integrating acupuncture into the management of attention-deficit/hyperactivity disorder among children and adolescents now opportune and evidence-based? A systematic review with meta-analysis and trial sequential analysis","authors":"Fei-Yi Zhao ,&nbsp;Yan Xu ,&nbsp;Gerard A. Kennedy ,&nbsp;Russell Conduit ,&nbsp;Wen-Jing Zhang ,&nbsp;Ting Jiang ,&nbsp;Peijie Xu ,&nbsp;Yuen-Shan Ho ,&nbsp;Qiang-Qiang Fu ,&nbsp;Chin-Moi Chow","doi":"10.1016/j.ctim.2025.103163","DOIUrl":"10.1016/j.ctim.2025.103163","url":null,"abstract":"<div><h3>Background and aim</h3><div>The use of acupuncture is becoming increasingly popular in the management of attention-deficit/hyperactivity disorder (ADHD). This systematic review consolidates evidence on acupuncture’s efficacy and safety for treating ADHD in children and adolescents.</div></div><div><h3>Methods</h3><div>Controlled clinical trials assessing acupuncture against waitlist-control, placebo or active controls, or as an adjunct treatment were systematically searched across seven databases from inception to November 2024. Cochrane criteria were adhered to.</div></div><div><h3>Results</h3><div>We reviewed 25 studies with 1758 participants. None compared acupuncture to placebo or behavioral therapy. Subdomain analysis of the Conners’ Parent Rating Scale indicated that acupuncture and Methylphenidate had comparable effects on <em>Conduct Problems</em> [<em>SMD</em> = 0.03, 95 %<em>CI</em> (-0.93, 0.99), <em>p</em> = 0.95] and <em>Learning Problems</em> [<em>SMD</em> = 0.29, 95 %<em>CI</em> (-0.38, 0.97), <em>p</em> = 0.39], but acupuncture was more effective in controlling <em>Impulsive/Hyperactive</em> symptoms [<em>SMD</em> = -1.71, 95 %<em>CI</em> (-2.08, −1.35), <em>p</em> &lt; 0.01]. Insufficient sample size prevented confirmation of potential false positives. Acupuncture was safer and reduced Methylphenidate-related side-effects, including appetite loss, sleep disturbances, dry mouth, abdominal pain, and constipation. Acupuncture combined with behavioral therapy outperformed behavioral therapy alone in improving <em>Psychosomatic</em> symptoms [<em>SMD</em> = -0.88, 95 %<em>CI</em> (-1.54, −0.23), <em>p</em> &lt; 0.01]. In the Integrated Visual and Auditory Continuous Performance Test, ADHD patients receiving acupuncture alongside conventional care performed better than those receiving conventional care alone. Nevertheless, the methodological quality of the included trials was very low to low, with significant bias risk, and 88 % lacked follow-up.</div></div><div><h3>Conclusions</h3><div>Acupuncture may offer an alternative for children and adolescents with ADHD who are intolerant to medication (primarily Methylphenidate). When combined with medication or behavioral therapy, it appeared more effective in ameliorating hyperactivity/impulsivity, inattention and conduct problems than standard treatments alone. It is also safe and well-tolerated. However, the supporting evidence is of low quality, and well-designed randomized controlled trials are needed. Thus, it is premature to recommend acupuncture as an alternative or adjunctive therapy for ADHD management.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"90 ","pages":"Article 103163"},"PeriodicalIF":3.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630028","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":"Motor learning-based clinical pilates training for the Parkinson’s disease rehabilitation @Parkinsonpilates: A parallel group, randomised controlled trial with 3-month follow-up","authors":"Fahriye Coban ,&nbsp;Beliz Belgen Kaygisiz ,&nbsp;Ferda Selcuk","doi":"10.1016/j.ctim.2025.103161","DOIUrl":"10.1016/j.ctim.2025.103161","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the effect of integrated motor learning clinical pilates protocol we developed for patients with Parkinson’s Disease (pwPD) on providing enduring motor skills in walking, balance, reaction time, cadence, and functional mobility at 3-months follow-up.</div></div><div><h3>Design</h3><div>A parallel-group, randomized controlled trial (RCT).</div></div><div><h3>Setting</h3><div>XXX Medical Center, XXX, and XXX Physiotherapy and Rehabilitation Center, Nicosia.</div></div><div><h3>Participants</h3><div>32 pwPD with Hoehn&amp;Yahr stages 2–3 were randomly assigned to the Parkinsonpilates Group (PP) and the Conventional Physiotherapy (CP) Group.</div></div><div><h3>Interventions</h3><div>Both groups received 60 min of training, twice a week, and a home physiotherapy program 4 times a week, for 12 weeks. The intervention group received PP, while the CP group received general physiotherapy training for PD.</div></div><div><h3>Main outcome measures</h3><div>The primary outcomes were untimed Gait and Balance Scale, Cadence, and Nelson Foot Reaction Test scores. The secondary outcomes were The Unified Parkinson's Disease Rating Scale-III subscales, Timed Up and Go Test, Functional Reach Test, and Berg Balance Scale. Outcomes were convened 4 times: pre-test, 6. weeks, post-treatment, and after 3-month follow-up.</div></div><div><h3>Results</h3><div>At post-test, gait and balance, reaction time, functional mobility, static and dynamic balance showed a significant improvement in PP compared to CP, and the motor examination was similar(p &gt; .05). In addition to these results at follow-up, functional mobility was similar(p &gt; .05) and cadence(p &lt; .05) showed a significant improvement in PP. In addition, according to pairwise comparisons, the PP showed a significant improvement in cadence and reaction time in all 4 measures compared to CP.</div></div><div><h3>Conclusions</h3><div>More studies are needed to clarify the effects of the program we developed for PD. It should not be ignored that our protocol can be improved again according to the suggestions of future studies.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"90 ","pages":"Article 103161"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591771","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":"Effectiveness and safety of acupoint embedding therapy for treating intractable facial paralysis: A systematic review and meta-analysis","authors":"Xiaotong Guo ,&nbsp;Fenglei Zai ,&nbsp;Xianliang Tang ,&nbsp;Yongkang Deng ,&nbsp;Jianghui Cheng","doi":"10.1016/j.ctim.2025.103162","DOIUrl":"10.1016/j.ctim.2025.103162","url":null,"abstract":"<div><h3>Objective</h3><div>Limited systematic reviews have explored the impact of acupoint embedding (AE) therapy on intractable facial paralysis (IFP). This review presents the current evidence on the efficacy and safety of AE therapy in the treatment of IFP.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang databases were systematically searched from inception to February 2024 to identify randomized controlled trials (RCTs) without language restrictions. Data extraction and analysis were independently conducted by two reviewers. The Risk of Bias was assessed using the Risk of Bias tool (version 2.0), and a meta-analysis was performed using the RevMan software (V5.4).</div></div><div><h3>Setting</h3><div>Eighteen RCTs involving 1881 patients were included in the analysis.</div></div><div><h3>Results</h3><div>AE therapy demonstrated a higher total effective rate (relative risk [RR]: 1.28; 95 % confidence interval [CI]: 1.13–1.44; P &lt; 0.0001), cure rate (RR: 1.81; 95 % CI: 1.05–3.12; P = 0.03), and facial nerve function score (standardized mean differences [SMD]: 1.57; 95 % CI: 1.16–1.99; P &lt; 0.00001) compared to that of manual acupuncture. Additionally, AE therapy showed a higher total effective rate (RR: 1.16; 95 % CI: 1.10–1.22; P &lt; 0.00001) and cure rate (RR: 1.70; 95 % CI: 1.46–1.98; P &lt; 0.00001) in comparison to that of electroacupuncture. However, there were no significant differences in facial nerve function scores(SMD:2.04; 95 % CI: −1.25–5.32; P = 0.22) or adverse reactions(RR: 1.16; 95 % CI: 0.35–3.78; P = 0.81) between AE therapy and electroacupuncture therapy. Evidence supporting the efficacy and safety of AE treatment is also insufficient.</div></div><div><h3>Conclusion</h3><div>Most of the included studies indicated that AE therapy was more effective than MA/EA therapy for IFP. However, the quality of evidence for the majority of these studies was low, and all were conducted in China, where limited information has been reported regarding the safety of AE therapy.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"90 ","pages":"Article 103162"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623963","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":"Alternative therapies in chronic non-cancer pain management: A scoping review of randomized controlled trials","authors":"Yuxing Zhang ,&nbsp;Bangqi Wu ,&nbsp;Peng Qin ,&nbsp;Yupei Cheng ,&nbsp;Yuyan Chen","doi":"10.1016/j.ctim.2025.103154","DOIUrl":"10.1016/j.ctim.2025.103154","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pain is one of the most challenging health problems in modern society, placing significant burdens on individuals and healthcare systems. While pharmacological treatments remain the primary approach to pain management, their limitations often restrict choices for both clinicians and patients. In contrast, complementary therapies are gaining recognition for their potential effectiveness and safety. However, the current literature lacks a comprehensive summary of the role of complementary therapies in chronic pain management.</div></div><div><h3>Objective</h3><div>This review aims to summarize the complementary therapies used in chronic non-cancer pain management, assess their practical applications, identify research gaps and limitations, and provide a comprehensive perspective for the development of chronic non-cancer pain management and personalized pain management strategies.</div></div><div><h3>Methods</h3><div>This scoping review followed the PRISMA-ScR guidelines. Randomized controlled trials (RCTs) published in the last decade were retrieved from PubMed and Web of Science using the keywords \"chronic pain\" and \"complementary therapy.\" Non-English studies were excluded.</div></div><div><h3>Results</h3><div>A total of 848 RCTs were identified, of which 128 met the inclusion criteria. The included studies addressed chronic musculoskeletal pain (102 studies), chronic visceral pain (5 studies), chronic neuropathic pain (7 studies), and 13 studies that did not specify the pain type. The complementary therapies investigated included acupuncture, manual therapy, exercise therapy, psychological interventions, mind-body therapies, and physical modalities.</div></div><div><h3>Conclusion</h3><div>This review provides preliminary evidence supporting the efficacy and safety of complementary therapies in the management of chronic non-cancer pain. However, methodological and quality-related limitations were identified in the included studies. Future high-quality RCTs are needed to validate the long-term efficacy of these therapies, explore their mechanisms of action, and provide stronger evidence for their clinical application.</div></div><div><h3>Registration</h3><div>This scoping review is registered on the Open Science Framework (OSF) under the following DOI: <span><span>https://doi.org/10.17605/OSF.IO/67K32</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"90 ","pages":"Article 103154"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609991","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":"Efficacy of biofeedback for migraine: A systematic review and meta-analysis","authors":"Prayash Paudel,&nbsp;Asutosh Sah","doi":"10.1016/j.ctim.2025.103153","DOIUrl":"10.1016/j.ctim.2025.103153","url":null,"abstract":"<div><div>Migraine, a severe headache accompanied by nausea, photophobia and phonophobia, can be controlled with pharmacological as well as non-pharmacological therapies. In biofeedback, patients learn to voluntarily modify their bodily reactions through feedback mediated awareness of physiological parameters, thus promoting relaxation, reducing stress and preventing migraine attacks. We aim to assess the efficacy of biofeedback on adult patients with migraine. Study protocol was registered on PROSPERO with reference number CRD42024606671. PubMed, Embase and Google Scholar were searched for randomized controlled trials from 2000 to 2024 in English that have evaluated the administration of biofeedback to the adult patients with migraine. High quality studies were included after RoB 2.0 Risk of Bias assessment. ANOVA with inverse variance weighting was used to compare mean differences across groups with 95 % confidence interval. Nine studies (558 participants) and three studies (278 participants) respectively qualified for comparison of biofeedback with waiting list control and active treatment. Biofeedback significantly reduced headache frequency and severity compared to waiting-list control. However, it showed no significant difference in headache frequency when compared to active treatments such as pharmacotherapy or cognitive behavioral therapy. Additionally, improvements in migraine-related disability, depression, anxiety, and quality of life were reviewed. This meta-analysis confirms that biofeedback is an effective non-pharmacological intervention for reducing headache frequency and severity in migraines. Additionally, it appears to provide synergistic benefits when combined with pharmacotherapy. However, future studies should focus on the cost-effectiveness and accessibility of home-based and app-based biofeedback to determine its broader clinical applicability.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"90 ","pages":"Article 103153"},"PeriodicalIF":3.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596425","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":"Effects of Mawangdui exercise intervention on the pulmonary function, physical fitness and quality of life in stable chronic obstructive pulmonary disease patients: A randomised controlled trial","authors":"Zhenggang Zhu ,&nbsp;Ayu Suzailiana Muhamad ,&nbsp;Norsuhana Omar ,&nbsp;Foong Kiew Ooi ,&nbsp;Xiaoyan Pan ,&nbsp;Marilyn Li Yin Ong","doi":"10.1016/j.ctim.2025.103152","DOIUrl":"10.1016/j.ctim.2025.103152","url":null,"abstract":"<div><h3>Background</h3><div>Physical exercise intervention in pulmonary rehabilitation is recommended to increase strength, endurance, and flexibility in chronic obstructive pulmonary disease (COPD). However, certain physical intervention may be restrictive to COPD patients, as it induces fatigue and shortness of breath. Mawangdui exercise, a low-to-medium-intensity aerobic exercise, has been gaining popularity in China as an adjuvant physical therapy, particularly for patients with contraindications to exercise, to improve their health.</div></div><div><h3>Objective</h3><div>To investigate the effectiveness of the traditional Chinese Mawangdui exercise for patients with COPD in a mild to moderate stable stage.</div></div><div><h3>Methods</h3><div>A total of 54 COPD patients in stable stage (Mawangdui group, n = 27; control group, n = 27) were enroled for a period of 12-weeks. The Mawangdui group practised the Mawangdui exercise, while the control group maintained daily activities without additional exercise. The outcomes measurements were pulmonary function, exercise capacity, back-leg-chest muscle strength, sit-and-reach flexibility, dyspnoea symptoms, and quality of life. The outcomes were assessed at baseline, 24 h, 6 weeks, and 12 weeks post-intervention.</div></div><div><h3>Results</h3><div>Improvements were observed for Borg CR-10 score, SpO₂, BMI, body fat%, fat mass, flexibility mMRC, and SGRQ scores (<em>p</em> &lt; 0.05) at 12 weeks. At week 12, Mawangdui group showed improved exercise capacity (6MWT mean difference 63.39 m, CI 48.36－78.40), back-leg-chest muscle strength (mean difference 5.92 kg, CI −2.57－-14.41), and dyspnoea (CAT score mean difference −5.50, CI −6.42－-4.59) in per-protocol population. However, FEV₁, FVC, FEV₁% pred, and fat-free mass did not show improvements with Mawangdui exercise.</div></div><div><h3>Conclusion</h3><div>COPD patients in stable stage who performed Mawangdui exercise for 12 weeks improved exercise capacity, dyspnoea, muscle strength, flexibility, BMI, body fat%, fat mass and quality of life. Therefore, Mawangdui exercise is recommended for COPD patients in the stable stage to improve physical fitness and quality of life.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103152"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540426","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 music intervention on dental anxiety and fear: A bibliometric analysis of RCTs from 2004 to 2024","authors":"Yena Gan ,&nbsp;Jinwei Huang ,&nbsp;Sheng Han ,&nbsp;He Xu ,&nbsp;He Zhu ,&nbsp;Duoduo Li ,&nbsp;Zening Wei ,&nbsp;Feng Sun ,&nbsp;Zhigang Cai","doi":"10.1016/j.ctim.2025.103148","DOIUrl":"10.1016/j.ctim.2025.103148","url":null,"abstract":"<div><h3>Background</h3><div>Dental treatments, especially invasive procedures, often induce anxiety and fear, impacting future treatment adherence. Music intervention, a non-pharmacological approach, has shown promise in reducing anxiety and enhancing well-being, but further research is needed to explore its application in dental settings and the influence of factors like music type, duration, and volume.</div></div><div><h3>Objective</h3><div>To assess the effects of music interventions on dental anxiety and fear, analyze research trends, and identify knowledge gaps through a bibliometric analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>Data from eligible studies were extracted through a comprehensive search. Descriptive bibliometrics, citation analysis, and keyword analysis were performed to assess research outputs, distribution, hotspots, and trends. Different human development indices (HDI) were used to analyze variations in publication year, sex distribution, and interventions across countries.</div></div><div><h3>Results</h3><div>This study included 46 randomized controlled trials (RCTs) from 2004 to 2024, with a mean annual growth rate of 5.95 %. India, Japan, and Turkey led the research output and citations. Approximately 4112 participants, with 45.68 % males were enrolled. Most RCTs focused on adults (65.22 %) and used passive music interventions (73.91 %). The most common treatment was dental extraction (39.13 %), with classical music being the predominant intervention (60.87 %). The control group were often blank (80.43 %). Various indicators of anxiety and fear have been reported. Significant differences were found in the sex distribution among the different HDI ranks (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study outlined the research profile of music interventions for reducing anxiety and fear during dental treatments, with India, Japan, and Turkey leading in terms of output. The most frequently studied intervention is classical music, which is typically used preoperatively. Notable sex distribution differences were observed across HDI groups. Future research trends should include more extensive trials, personalized interventions, standardized guidelines, and enhanced collaboration to optimize patient engagement and emotional regulation.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103148"},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519750","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 state of evidence in acupuncture: A review of metaanalyses and systematic reviews of acupuncture evidence (update 2017–2022)","authors":"Moritz Hempen ,&nbsp;Josef Hummelsberger","doi":"10.1016/j.ctim.2025.103149","DOIUrl":"10.1016/j.ctim.2025.103149","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Over the last decades, acupuncture research has increased drastically. As a result, it has become more and more difficult to oversee the amount of evidence concerning its effect in various medical conditions. Different comparative reviews aimed to roughly assess individual strength of acupuncture evidence, covering the years 2005–2017. Our review intends to assess the level of acupuncture evidence for any medical condition available, concerning the years 2017–2022.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We searched the pubmed database for ‘acupuncture’ and filtered the results towards systematic reviews and metanalyses (SR/MA). Results were allocated towards medical disciplines and sorted to medical conditions. Each SR/MA was rated concerning &lt;em&gt;quality of review&lt;/em&gt; (QoR), &lt;em&gt;quality of data&lt;/em&gt; (QoD), and &lt;em&gt;quality of evidence&lt;/em&gt; (QoE). To facilitate a rough overview, results were assessed into either of four categories: i) &lt;em&gt;evidence of positive effect&lt;/em&gt;, ii) &lt;em&gt;evidence of potential positive effect&lt;/em&gt;, iii) &lt;em&gt;insufficient/unclear evidence&lt;/em&gt;, iv) &lt;em&gt;no evidence of effect/evidence of no effect&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;After considering exclusion criteria, 862 SR/MA remained for evaluation. Results were allocated and sorted as described, resulting in 184 medical conditions. Of these, in ten medical conditions SR/MA supported &lt;em&gt;evidence of positive effect&lt;/em&gt;: chronic pain, low-back pain, knee osteoarthritis, postoperative nausea and vomiting (PONV), migraine, tension-type headache, cancer-related fatigue, menopausal symptoms, female infertility (additional to medical reproductive treatment), chronic prostatitis/chronic pelvic pain syndrome in men. In another 82 medical conditions SR/MA supported &lt;em&gt;evidence of potential positive effect,&lt;/em&gt; in another 86 medical conditions SR/MA revealed &lt;em&gt;unclear/insufficient evidence,&lt;/em&gt; and in another six medical conditions &lt;em&gt;no evidence of effect/evidence of no effect&lt;/em&gt; was found. Compared with previous reviews until the year 2017, the number of medical conditions with higher quality evidence levels has increased, namely &lt;em&gt;evidence of positive effect&lt;/em&gt; and &lt;em&gt;evidence of potential positive effect&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion and conclusion&lt;/h3&gt;&lt;div&gt;Compared to previous years, the amount and quality of acupuncture evidence has increased in the years 2017–2022. In total, 862 included SR/MA resulted in a comparative review of 184 medical conditions. &lt;em&gt;Evidence of positive effect&lt;/em&gt; was revealed ten medical conditions, another 82 showed &lt;em&gt;evidence of potential positive effect&lt;/em&gt;. 86 medical indications showed &lt;em&gt;insufficient evidence&lt;/em&gt; for a firm conclusion, six conditions showed &lt;em&gt;no evidence of effect/evidence of no effect&lt;/em&gt;. Although general quality of evidence has dramatically increased compared to the previous years, lack of underlying high-quality trials in some cases seems to compromise a cons","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103149"},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531228","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":"Oral probiotic supplementation to alleviate diarrhea induced by fluoropyrimidines or irinotecan-based chemotherapy: A systematic review and meta-analysis","authors":"Tippawan Siritientong ,&nbsp;Daylia Thet ,&nbsp;Nattawut Leelakanok ,&nbsp;Nutthada Areepium","doi":"10.1016/j.ctim.2025.103151","DOIUrl":"10.1016/j.ctim.2025.103151","url":null,"abstract":"<div><h3>Background</h3><div>Fluoropyrimidines and irinotecan cause diarrhea, which can be particularly severe in some cases. Probiotic supplementation is a potential option for managing chemotherapy-induced diarrhea. This study aims to evaluate the efficacy and safety of probiotics in managing diarrhea induced by fluoropyrimidine or irinotecan-based chemotherapy in cancer patients.</div></div><div><h3>Methods</h3><div>A literature search was conducted in Cochrane Library, PubMed, ScienceDirect, SciFinder, and Scopus in August 2023. Observational and prospective studies of cancer patients receiving 5-fluorouracil, capecitabine, or irinotecan were included. RevMan (version 5.4.1) was used for statistical analysis. The study protocol was registered in PROSPERO.</div></div><div><h3>Results</h3><div>Of the 9400 records, 24 and 14 studies were included in the systematic review and meta-analysis, respectively. Most studies provided a combination of probiotic strains to patients from the initiation to the completion of chemotherapy cycles. Probiotic supplementation significantly reduced all grade diarrhea (RR = 0.40; 95 % CI: 0.27, 0.60; <em>P</em> &lt; 0.00001, I²: 0 %), nausea and vomiting (RR = 0.49; 95 % CI [0.37, 0.67]; <em>P</em> &lt; 0.00001, I²: 0 %), bloating (RR = 0.27; 95 % CI [0.11, 0.69]; <em>P</em> = 0.006, I²: 0 %) and anorexia (RR = 0.62: 95 % CI [0.43, 0.90]; <em>P</em> = 0.01, I²: 39 %) compared to controls. Absolute risk reductions (ARR) ranged from 22.7 % to 28.5 %, with the number needed to treat (NNT) value of 3–5. Moreover, probiotics improved intestinal microbial balance and symptom scales of quality of life.</div></div><div><h3>Conclusions</h3><div>Probiotic supplementation is a promising option to manage chemoradiotherapy-induced diarrhea without serious side effects in cancer patients receiving fluoropyrimidines or irinotecan-based regimens. Given the clinically meaningful ARR and favorable NNT values, probiotics may have a role in clinical practice. However, larger trials are needed to standardize probiotic strain, dosage, duration, and target patient subgroups.</div></div><div><h3>Systematic review registration</h3><div>PROSPERO database (CRD42023473324)</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103151"},"PeriodicalIF":3.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491039","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":"Efficacy of melatonin as adjunctive therapy for sepsis: A meta-analysis of randomized controlled trials","authors":"Zhuangzhuang Sun ,&nbsp;Cheng Yu ,&nbsp;Zhaopeng Zhang ,&nbsp;Chunjie Hu ,&nbsp;Xin Li ,&nbsp;Xiheng Dong ,&nbsp;Ru Zhang ,&nbsp;Zhirun Zhang ,&nbsp;Tonggang Zhu ,&nbsp;Xin Su ,&nbsp;Junpeng Guo","doi":"10.1016/j.ctim.2025.103147","DOIUrl":"10.1016/j.ctim.2025.103147","url":null,"abstract":"<div><h3>Background</h3><div>This study systematically evaluates the therapeutic efficacy of melatonin as an adjunctive therapy, aiming to determine its potential to reduce mortality and mitigate inflammatory responses in patients with sepsis.</div></div><div><h3>Methods</h3><div>A search was conducted across PubMed, Web of Science, Cochrane Library, and Embase databases. The Cochrane Collaboration Risk of Bias (ROB) tool was systematically employed to assess the potential for bias in the relevant studies. The <em>I²</em> statistic was employed to evaluate heterogeneity among the studies. Potential publication bias was assessed using Begg's test. Sensitivity analysis was performed to examine the stability of the results. Additionally, a GRADE evaluation of the evidence level.</div></div><div><h3>Results</h3><div>This meta-analysis encompassed a total of seven randomized controlled trials involving 421 patients diagnosed with sepsis. The primary results indicated that the mortality rate in the intervention group was significantly lower than that in the control group, suggesting that melatonin may effectively reduce mortality among sepsis patients [<em>OR</em> = 0.42, <em>95 % CI</em>: 0.23–0.77, <em>P</em> = 0.005]. Additionally, the CRP levels in the intervention group were markedly lower than those in the control group, providing evidence that melatonin possesses anti-inflammatory properties that may help decrease inflammatory markers in sepsis patients [<em>SMD</em>= -4.00, <em>95 % CI</em>: −6.47 to −1.53, <em>P</em> = 0.001]. Furthermore, Secondary outcome results showed no statistically significant differences in sequential organ failure assessment (SOFA) scores, length of hospital stay, and adverse effects. A sensitivity analysis confirmed the robustness of the findings from the included studies. By applying the GRADE system to evaluate the quality of evidence, we found the evidence in four grades: one rated as high quality, one as medium quality, and three rated as low quality.</div></div><div><h3>Conclusion</h3><div>Melatonin, when used as an adjuvant therapy, significantly reduces mortality and lowers the levels of the inflammatory marker CRP in patients with sepsis, while also improving their physical condition. However, due to the limited number and quality of the articles, these conclusions warrant further verification through the conduct of additional high-quality research.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103147"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482413","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}