Complementary therapies in medicine最新文献

{"title":"Evaluation of visual and vibratory guidance for resonance frequency breathing.","authors":"Xing Mei, Hideaki Hasuo, Hiroko Sakuma, Yuko Shida, Junji Nishiyama","doi":"10.1016/j.ctim.2026.103460","DOIUrl":"https://doi.org/10.1016/j.ctim.2026.103460","url":null,"abstract":"<p><strong>Introduction: </strong>Resonance frequency breathing is a non-pharmacological self-regulation technique used in heart rate variability biofeedback and complementary health practices. However, optimal guidance methods for home-based and self-directed practice remain unclear.</p><p><strong>Methods: </strong>We conducted a randomized, open-label crossover trial in 72 healthy volunteers. Participants performed 4min of paced breathing at a predicted resonance rate under three conditions (visual guidance, vibratory guidance, no guidance), with 3-min rest periods before and after each session. The primary outcome was the change in short-term heart rate variability. The secondary outcome was the percentage of time judged as \"resonant\" based on blinded waveform assessment.</p><p><strong>Results: </strong>Both visual and vibratory guidance were associated with significantly greater increases in heart rate variability during and after paced breathing compared with no guidance (P < 0.001). No significant difference was observed between visual and vibratory guidance (P = 0.360). The proportion of time judged as resonant was significantly higher with both guidance methods than with no guidance (P < 0.001), without differences between guidance modalities (P = 0.110).</p><p><strong>Conclusion: </strong>Visual and vibratory guidance may facilitate adherence to paced breathing at a predicted resonance rate and increase short-term heart rate variability under these conditions.</p><p><strong>Trial registration: </strong>UMIN000052363. Registered 1 October 2023.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103460"},"PeriodicalIF":4.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206713","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":"Cinema-based interventions for coping with life-threatening illness, dying or loss: A systematic review and realist synthesis.","authors":"Raquel Ibanez-Monforte, Pedro Sigaud-Sellos, Andrea Rodriguez-Prat","doi":"10.1016/j.ctim.2026.103446","DOIUrl":"https://doi.org/10.1016/j.ctim.2026.103446","url":null,"abstract":"<p><p>Cinematherapy is increasingly being used as a complementary therapy and psychosocial approach in clinical settings, including end-of-life contexts. However, more needs to be understood about the mechanisms underpinning its therapeutic potential. The aim of this study was to identify cinema-based interventions that have been used as a resource for helping patients cope with life-threatening illness, dying or loss, focusing on the contexts in which they have been applied, the mechanisms through which they appear to operate, and the outcomes achieved. To this end we conducted a systematic review and realist synthesis of the literature, with reporting guided by the PRISMA statement and RAMESES standards. The review identified 24 interventions implemented with two broad aims (contexts of use): (1) improving the hospital experience, and (2) as a tool in psychotherapy. In terms of the mechanisms underpinning their therapeutic potential, the analysis suggests that this is achieved primarily through psychological processes associated with narrative transportation, which can be facilitated by creating a cinema-like environment and through the targeted selection of content. In terms of outcomes, studies reported a positive impact on a range of variables, including psychological well-being, communication, personal reflection, social connectedness, anxiety, fear, and pain. Further research is required to define the specific esthetic, narrative, and thematic aspects of films that may contribute to their therapeutic potential. There is also a need for in-depth exploration of the perspectives of both patients and professionals so as to develop a more systematic approach to the use of cinematherapy in these clinical contexts.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103446"},"PeriodicalIF":4.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191947","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":"Reporting quality assessment of sham acupuncture randomized controlled trials for acupuncture intervention in glaucoma.","authors":"Yi-Fan Lei, Xin-Yun Huang, Shi-Yong Xue, Yao-Jia-Ni Cao, Xue-Jun Wang, Can Yang, Jue Hong, Xiao-Peng Ma","doi":"10.1016/j.ctim.2026.103452","DOIUrl":"10.1016/j.ctim.2026.103452","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the reporting quality of sham-acupuncture-randomized controlled trials (RCTs) investigating acupuncture intervention for glaucoma.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, the Cochrane Library, Embase, Scopus, Web of Science, EBSCO, China National Knowledge Infrastructure (CNKI), Wanfang Database, SinoMed, and China Science and Technology Journal Database (VIP) for Chinese and English RCTs on acupuncture intervention for glaucoma published from database inception until August 2025. The Consolidated Standards of Reporting Trials 2025 (CONSORT), Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA), and the Sham Acupuncture Reporting Guidelines and a Checklist in Clinical Trials (SHARE) were used by the investigators to assess the Overall Quality Score (OQS) of the RCTs that met the pre-defined inclusion criteria. Inter-rater agreement was evaluated using Cohen's κ coefficient.</p><p><strong>Results: </strong>The systematic search initially identified 1289 relevant records. After a stepwise screening process, it was found that RCTs utilizing sham acupuncture controls were very limited; consequently, only 6 RCTs meeting the pre-defined criteria were ultimately included. According to the CONSORT statement, the median OQS for the 6 RCTs was 16 items (range: 10-23). Among all CONSORT items, the positive rate for 9 items (21%) was greater than 80%, while for 20 items (48%) it was below 20%. Based on the STRICTA guidelines, the median OQS for the 6 RCTs was 10.5 items (range: 8-14). For the STRICTA guidelines, the positive rate for 6 items (35%) was greater than 80%, and for 1 item (6%) it was below 20%. According to the SHARE guidelines, the median OQS for the 6 RCTs was 6.5 items (range: 3-10). For the SHARE checklist, 3 items (18%) had a reporting rate > 80%, while 10 items (53%) had a rate < 20%. The overall average reporting rates based on CONSORT, STRICTA, and SHARE were 39.7%, 62.7%, and 35.1%, respectively.</p><p><strong>Conclusion: </strong>The current reporting quality of sham acupuncture RCTs on acupuncture intervention for glaucoma is generally suboptimal. There is a particular and urgent need to improve the reporting of detailed information regarding the sham acupuncture control. It is recommended that future relevant RCTs strictly adhere to the CONSORT statement, STRICTA standards, and SHARE checklist for standardized reporting.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103452"},"PeriodicalIF":4.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191932","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":"Assessing the safety of herbal medicine use among type 2 diabetes mellitus patients: A systematic review and meta-analysis","authors":"Emna Boulares ,&nbsp;Nicola Luigi Bragazzi ,&nbsp;Tan Sabrina Chen Yin ,&nbsp;Soo Jeung Choi ,&nbsp;Jung Hwan Park ,&nbsp;Dongwoon Han","doi":"10.1016/j.ctim.2026.103319","DOIUrl":"10.1016/j.ctim.2026.103319","url":null,"abstract":"<div><h3>Background</h3><div>Herbal medicines (HM) use among type 2 diabetes mellitus (T2DM) patients has grown tremendously despite the existence of conventional treatments. However, evidence on their safety, potential side effects, and interactions remains scarce. This systematic review and meta-analysis aim to determine the global prevalence of HM use among T2DM patients and assess the safety and potential interactions.</div></div><div><h3>Methods</h3><div>A systematic search of four electronic databases was conducted until March 2024. Data were extracted and then assessed through an adapted quality appraisal tool. A meta-analysis estimated the pooled prevalence of HM use among T2DM patients and examined predictors of use. Identified herbs were classified based on safety and potential interactions with pharmacological treatments. The study followed PRISMA guidelines.</div></div><div><h3>Results</h3><div>Twenty-two cross-sectional studies from 19 countries were included. The global prevalence of HM use among T2DM patients was 53%, with significant regional variations. The highest prevalence of HM use among T2DM patients is in the African region, accounting for 39.8% of global HM use. Among 49 identified herbs, <em>Opuntia ficus-indica L., Trigonella foenum graecum L.</em>, <em>Allium sativum L.</em>, and <em>Cinnamomum verum J</em>. were the most commonly used. The safety classification reported 7 contraindicated herbs and 19 requiring caution, and 23 considered safe for use. Additionally, 12 herbs reported potential pharmacological interactions.</div></div><div><h3>Conclusions</h3><div>Although the use of HM is widespread globally, multiple herbs pose safety concerns. Therefore, to preserve patients’ safety, it is essential to avoid using contraindicated herbs and to seek healthcare practitioner supervision.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103319"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988602","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":"Influence of acupuncture and moxibustion on postoperative gastrointestinal dysfunction among patients with gastrointestinal cancer: A network meta-analysis","authors":"Yudi Wu ,&nbsp;Xiuxiu Li ,&nbsp;Xinwei Tan ,&nbsp;Jing Tan ,&nbsp;Xiaorong Chang","doi":"10.1016/j.ctim.2026.103331","DOIUrl":"10.1016/j.ctim.2026.103331","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate and compare the relative efficacy and safety of acupuncture and moxibustion interventions for the recovery of gastrointestinal function and the incidence of adverse reactions after gastrointestinal cancer (GIC) surgery.</div></div><div><h3>Methods</h3><div>Eight databases were retrieved up to July 2025. The observation indicators included: time to first flatus, defecation, food intake, and bowel sound; incidence of postoperative adverse reactions (nausea and vomiting, abdominal distension and diarrhea, and ileus); and clinical efficacy rate. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Statistical analysis was conducted via Bayesian network meta-analysis implemented in R. Intervention efficacy was quantitatively ranked using the surface under the cumulative ranking curve (SUCRA), with relevant diagrams generated in Stata (version 18.0).</div></div><div><h3>Results</h3><div>In total, 43 randomized controlled trials (RCTs) were included in this study, involving 4019 patients, to evaluate the efficacy of 10 interventions of acupuncture and moxibustion. The network meta-analysis revealed that electroacupuncture was the most effective in shortening the time to first flatus after surgery (MD = −3.8, 95 % CI [-7.06, −0.61]) and the time to first defecation (MD = −4.97, 95 % CI [-9.61, −0.41]) (SUCRA = 75.1 %, SUCRA = 77.2 %). Parallel needling method (MD = −4.83, 95 % CI [-8.16, −1.45]) performed best in lessening the time to first postoperative bowel sound (SUCRA = 92.1 %). All interventions failed to significantly shorten the time to first food intake after surgery. In terms of clinical efficacy rate, moxibustion (MD = 1.54, 95 % CI [1.08, 2.3]) showed the best performance in ameliorating the overall clinical efficacy rate after surgery (SUCRA = 89.5 %). Thumbtack needle exerted the best effect in decreasing postoperative nausea and vomiting (RR = 6.7, 95 % CI [0.18, 269.63]) and abdominal distension and diarrhea (RR = 5.78, 95 % CI [1.07, 34.89]) (SUCRA = 76.1 %, SUCRA = 89.6 %).</div></div><div><h3>Conclusion</h3><div>Acupuncture and moxibustion therapy, as an adjunctive therapy, has exhibited favorable efficacy and safety in treating POGD related to GICs. RCTs of high quality are warranted to further ascertain these findings in the future.</div></div><div><h3>PROSPERO Registration number</h3><div>CRD42025111427</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103331"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218785","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":"Effectiveness comparisons of acupoint stimulation therapies for irritable bowel syndrome: A Bayesian network meta‑analysis","authors":"Jun Zhou ,&nbsp;Lamichhane Narendra ,&nbsp;Yi Guo ,&nbsp;Jing Huang ,&nbsp;Jiaqi Wang ,&nbsp;Jinghong Liang ,&nbsp;Xuetong Zhang ,&nbsp;Meidan Zhao ,&nbsp;Zhifang Xu","doi":"10.1016/j.ctim.2026.103332","DOIUrl":"10.1016/j.ctim.2026.103332","url":null,"abstract":"<div><h3>Background</h3><div>Irritable bowel syndrome (IBS) is a chronic functional disorder that significantly impacts patient health, causing physical discomfort and diminished quality of life. We aimed to compare various acupoint stimulation modalities for treating IBS using network meta-analysis (NMA).</div></div><div><h3>Methods</h3><div>We conducted a systematic search of five electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and ClinicalTrials.gov) for randomized controlled trials (RCTs) on acupoint stimulation interventions for IBS published from inception to November 8, 2024, without language restrictions. Two authors independently performed data extraction and assessed the risk of bias. Outcomes included symptom severity and quality of life. Bayesian NMA was conducted using STATA 14.0 and Open BUGS 3.2.3.</div></div><div><h3>Results</h3><div>We identified 12 RCTs that included three different acupoint stimulation interventions (1839 participants)—namely, acupuncture, moxibustion, and placebo. Our NMA results showed that the three acupoint stimulation intervention therapies were effective in reducing symptom severity and improving the quality of life for patients with IBS. The most effective acupoint stimulation intervention was moxibustion, which significantly reduced symptom severity (mean difference [MD] = 101.50; 95 % credible interval [CrI]: 80.36, 122.30) and improved quality of life (MD = −19.75; 95 % CrI: −28.86, −10.75) compared to conventional medication in patients with IBS. Moreover, the adverse events of all interventions were acceptable.</div></div><div><h3>Conclusions</h3><div>The NMA suggests that moxibustion was the most effective modality in alleviating symptom severity and improving quality of life in patients with IBS, followed by acupuncture.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103332"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218853","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":"Physical activity recommendations for pregnant women with gestational diabetes mellitus: A best evidence synthesis","authors":"Yue Peng ,&nbsp;Wei Zhu ,&nbsp;Yan Pu ,&nbsp;Yuyang Wang ,&nbsp;Yan Wang ,&nbsp;Biru Luo","doi":"10.1016/j.ctim.2026.103327","DOIUrl":"10.1016/j.ctim.2026.103327","url":null,"abstract":"<div><h3>Background</h3><div>A gap persists between recommendations and actual implementation of physical activity management for gestational diabetes mellitus (GDM), largely due to the limitations in the existing evidence. The objective of this study was to systematically identify and synthesize the available evidence regarding physical activity management for pregnant women with GDM.</div></div><div><h3>Methods</h3><div>A best-evidence synthesis was performed. Structured literature searches were conducted using the 6S model across selected evidence-based healthcare databases. Evidence extraction and synthesis followed the Joanna Briggs Institute’s (JBI) development process. The JBI Levels of Evidence (2014 edition) was applied to classify evidence levels, and the JBI Grades of Recommendation (2014 edition) was used to assign recommendation levels to each included piece of evidence.</div></div><div><h3>Results</h3><div>A total of 31,527 articles were identified, of which 7,936 were duplicates. After screening 23,591 titles and abstracts, 288 full-text articles were retrieved for eligibility assessment. Ninety-seven studies underwent quality assessment. Ultimately, 26 guidelines, 6 experts’ consensus, 19 systematic reviews, and 16 original studies were included for evidence extraction. Forty-seven distinct pieces of evidence were summarized across eight key aspects: assessment,exercise prescription, exercise timing, blood glucose management during exercise, sedentary and daily activities, health education, exercise promotion strategies, training, and effect evaluation.</div></div><div><h3>Conclusion</h3><div>Updating the limited evidence on the strategies to reduce sedentary behavior and the benefits and risks of different exercise methods would improve a better physical activity management in pregnant women with GDM.</div></div><div><h3>Contribution of the paper</h3><div>This study summarized the evidence on physical activity management in pregnant women with GDM.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103327"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776268","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":"Impact of a 12-week calisthenic exercise regimen on glycaemic regulation and cardiovascular endurance in individuals with type 2 diabetes Mellitus. A randomized controlled trail","authors":"Huma Khan ,&nbsp;Kamran Ali ,&nbsp;Tabish Fahim ,&nbsp;Sunil Kohli ,&nbsp;Zeinab A. Ali ,&nbsp;Elfatih Yagoub Ali ,&nbsp;Mastour Saeed Alshahrani ,&nbsp;Basant Hamdy Elrefaey ,&nbsp;Nasrin Mansuri ,&nbsp;Irshad Ahmad","doi":"10.1016/j.ctim.2026.103333","DOIUrl":"10.1016/j.ctim.2026.103333","url":null,"abstract":"<div><h3>Background and aims</h3><div>Diabetes Mellitus Type 2 (T2DM) is a metabolic disorder that is becoming increasingly common and can lead to a variety of problems. The purpose of this study was to explore the effects of calisthenic training exercises for twelve weeks on glucose levels, cardiovascular endurance, and body composition in people with type 2 diabetes.</div></div><div><h3>Experimental procedure</h3><div>Forty subjects, aged between 30 and 75 years, diagnosed with type 2 diabetes, clinically stable participated. Participants were randomized (1:1) using computer-generated sealed envelopes with assessor blinding; one pre-intervention group switch altered final allocation. Participants were randomly allocated into two groups: intervention group (n = 21), calisthenic exercises for twelve weeks under the supervision of physiotherapist, and control group (n = 19), followed routine medical treatment. The glycated haemoglobin (HbA1c) and the fasting/random glucose levels were the primary outcomes, whereas the body mass index, blood pressure, and the 6-minute walk distance (6MWD) were the secondary. Statistical analysis paired and independent t-tests were utilized, and confidence intervals of 95% were utilized.</div></div><div><h3>Results and conclusion</h3><div>Total of 40 participants who met the inclusion criteria, ages between 30–75 years, 20 subjects in each interventional and control group were assigned. Result of the study indicate that the intervention group exhibited noteworthy enhancements in HbA1c (9.60 ± 1.25–6.54 ± 0.92, p &lt; 0.001), body mass index (BMI) (26.51 ± 3.45–24.45 ± 2.98, p = 0.007), systolic blood pressure (136.38 ± 15.32–116.29 ± 12.47 mmHg, p &lt; 0.001), and six-minutes’ walk distance (400.00 ± 48.60 m to 517.14 ± 56.12 m, p &lt; 0.001). The results of this study indicate that structured calisthenic exercise is an efficient, low-cost, and easily accessible method for enhancing glycemic control and cardiovascular fitness in patients who have type 2 diabetes.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103333"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225488","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":"Inter-rater reliability and usability of CATHIS core for homeopathic intervention studies","authors":"Martin Loef ,&nbsp;Petra Weiermayer ,&nbsp;Katharina Gaertner ,&nbsp;Daniel Wrzałko ,&nbsp;Abhijit Dutta ,&nbsp;Subhranil Saha ,&nbsp;J.A.D.S. Lakshani ,&nbsp;Stephan Baumgartner ,&nbsp;Robbert van Haselen","doi":"10.1016/j.ctim.2026.103338","DOIUrl":"10.1016/j.ctim.2026.103338","url":null,"abstract":"<div><h3>Background</h3><div>The Critical Appraisal Tool for Homeopathic Intervention Studies (CATHIS) core is a streamlined appraisal tool for homeopathic intervention studies focusing on credibility, coherence, and clinical relevance. The aim of the research project was to evaluate its inter-rater reliability, feasibility, and face validity.</div></div><div><h3>Methods</h3><div>In a preregistered cross-sectional study, four raters independently applied CATHIS core to 28 trials (21 randomised controlled trials, 7 non-randomised studies on interventions) drawn from reviews on insomnia and hypertension; two external reviewers provided consensus ratings. Inter-rater reliability (IRR) was estimated using percent agreement, Fleiss’ κ, and Gwet’s AC2 (95% CIs). Feasibility was quantified as rating time and consensus time. Associations among the three domains were explored with correlation analyses and sensitivity checks.</div></div><div><h3>Results</h3><div>IRR varied markedly by domain. Credibility showed good agreement (Fleiss’ κ=0.66, 95% CI 0.57–0.74; AC2 =0.76, 0.71–0.82). Coherence yielded only poor-to-fair agreement (κ=0.28, 0.16–0.40; AC2 =0.41, 0.30–0.51). Clinical relevance was similarly limited (κ=0.32, 0.23–0.41; AC2 =0.36, 0.28–0.44). Individual ratings required on average 65.8 min, while consensus discussions averaged 17.7 min. Correlation analyses indicated heterogeneous and partly overlapping domain signals with limited interpretability. Face-validity responses reflected moderate-to-high acceptance but difficulties in consistent application.</div></div><div><h3>Conclusion</h3><div>CATHIS core yielded reproducible credibility ratings but only fair and operationally fragile agreement for coherence and clinical relevance, alongside non-trivial rating burden. Taken together, the current reliability profile is insufficient for confident use in systematic reviews. Targeted refinement appears warranted before broader implementation.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103338"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324958","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":"Effects of ashwagandha (Withania somnifera) on mental health in adults: A systematic review and dose–response meta-analysis of randomized controlled trials","authors":"Saleh A. Alsanie ,&nbsp;Fahad Saad Alhodieb ,&nbsp;Moein Askarpour","doi":"10.1016/j.ctim.2026.103325","DOIUrl":"10.1016/j.ctim.2026.103325","url":null,"abstract":"<div><h3>Background</h3><div>Ashwagandha (<em>Withania somnifera</em>), as an important herbal medicine, has been increasingly recognized for its role in mental health management, particularly in reducing stress and anxiety, and reflects the growing relevance of complementary and alternative medicine in addressing psychological well-being. The present study aims to investigate its effectiveness by pooling the evidence from existing randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>Major medical databases of PubMed, Scopus, and Web of Science Core Collection were searched. Eligible studies were included. Meta-analysis, meta-regression, non-linear dose-response analysis, and subgroup analyses were conducted. Standardized mean differences (SMDs) were calculated. P-values &lt; 0.05 were considered as statistically significant. The study protocol was registered in the PROSPERO database (CRD420251073134).</div></div><div><h3>Results</h3><div>Twenty-two studies met the eligibility criteria and were included. Meta-analysis revealed that supplementation with ashwagandha significantly improves stress (SMD = −5.88; 95 % CI: −8.15 to −3.60), depression (SMD = −5.68; 95 % CI: −8.43 to −2.94), and anxiety (SMD = −6.87; 95 % CI: −8.77 to −4.97). There was significant linear (coefficient = 0.005, P = 0.031) and non-linear (P-nonlinearity = 0.005) association between dosages of administered ashwagandha and stress levels.</div></div><div><h3>Conclusion</h3><div>Current evidence suggests that ashwagandha supplementation holds promising potential in alleviating symptoms of stress, anxiety, and depression. However, to strengthen these findings and translate them into clinical recommendations, well-designed, high-quality trials are still needed to address existing heterogeneity and to establish the most effective dosages and intervention durations.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103325"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124040","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}