European Journal of Integrative Medicine最新文献

{"title":"Efficacy and safety of moxibustion for diminished ovarian reserve infertility with kidney deficiency and blood stasis: a randomized controlled trial","authors":"Qianyang Zhu ,&nbsp;Katherine Thomas ,&nbsp;Sufan Ma ,&nbsp;Junling Zhou ,&nbsp;Qun Zhan ,&nbsp;Ping Zang ,&nbsp;Dan Wang ,&nbsp;Yajie Zhang ,&nbsp;Weina Zhu ,&nbsp;Huijia Li ,&nbsp;Jingjing Li ,&nbsp;Qian Shi ,&nbsp;Cairong Zhang","doi":"10.1016/j.eujim.2025.102576","DOIUrl":"10.1016/j.eujim.2025.102576","url":null,"abstract":"<div><h3>Introduction</h3><div>Diminished ovarian reserve (DOR) significantly affects female fertility and overall health. Emerging evidence suggests that moxibustion treatment improves DOR. <strong><em>Methods</em></strong>: In this multicenter randomized controlled trial, 154 patients with kidney deficiency and blood stasis–type diminished ovarian reserve (KDBSDOR) were randomized to moxibustion (76 cases) or sham moxibustion (SM) (78 cases) . Participants underwent 12 weeks of treatment followed by 12 weeks of follow-up. During the treatment period, three 7-day courses of daily (sham) moxibustion were administered, concurrently with three 28-day courses of Femoston. The primary outcome was pregnancy rate at the end of the follow-up period. Secondary outcomes included clinical efficacy, changes in hormone levels, relevant scales, and findings of ultrasound monitoring. Data were analyzed between groups based on the intention-to-treat principle.</div></div><div><h3>Results</h3><div>The pregnancy rate was higher in the moxibustion group (17.1 %) than in the sham moxibustion group (3.9 %) [risk ratio (RR) = 5.53, 95 % confidence interval (CI) (1.13, 27.00)]. The moxibustion group showed significantly greater odds of clinical efficacy than the sham moxibustion group [odds ratio (OR) = 3.32, 95 % CI (1.76, 6.25)]. Relative to the sham moxibustion group, the moxibustion group showed a greater reduction in luteinizing hormone (LH) levels and greater increases in E2, anti-Müllerian hormone (AMH), antral follicle count (AFC), and endometrial thickness (all <em>P</em> &lt; 0.05). After treatment, assessment scores decreased in both groups, with significant differences at different time points (<em>P</em> &lt; 0.001). After 12 weeks of treatment, significant between-group differences were observed in the traditional Chinese medicine clinical symptom score [mean difference (MD) = -1.405, 95 % CI (–2.031, –0.779)], menstrual integral score [MD = -0.931, 95 % CI (–1.397, –0.464)], Kupperman index [MD = -3.004, 95 % CI (–4.209, –1.800)], and self-rating anxiety scale score [MD = -3.425, 95 % CI (–4.900, –1.950)]. The patients’ KDBS physiques improved. There was no significant difference in the incidence of adverse events between the two groups (<em>p</em> = 0.209).</div></div><div><h3>Conclusions</h3><div>Moxibustion effectively improved clinical symptoms, menstruation, ovarian reserve function, hormonal balance, and pregnancy rate in patients with KDBSDOR-related infertility. This treatment is a potential alternative for women with DOR.</div><div>For a video summary of this article, see the Supplemental file 2 available online.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102576"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture therapy for atrophic gastritis with upper gastrointestinal symptoms: A systematic review and network meta-analysis","authors":"Jiashan Li ,&nbsp;Yuning Qin ,&nbsp;Liyun He ,&nbsp;Feifei Gao ,&nbsp;Ziyan Li ,&nbsp;Tingting Liu ,&nbsp;Zezhi Fan ,&nbsp;Yi Guo ,&nbsp;Tianyi Zhao ,&nbsp;Xue Zhao","doi":"10.1016/j.eujim.2025.102572","DOIUrl":"10.1016/j.eujim.2025.102572","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with atrophic gastritis (AG) exhibit typical upper gastrointestinal symptoms. Although acupuncture therapy can alleviate some gastrointestinal symptoms, it remains challenging to determine the optimal intervention for various symptoms. This study aimed to use network meta-analysis (NMA) to compare the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms.</div></div><div><h3>Methods</h3><div>Twelve databases were systematically searched from inception to 25 November 2024 to identify randomized clinical trials or retrospective cohort studies that evaluated the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms. The primary outcomes were stomachache, flatulence, heartburn, hiccups, and appetite disorder (assessed using the traditional Chinese medicine syndrome score, numeric rating scale or visual analogue score), and acid reflux (assessed using the symptom score). The Cochrane Risk of Bias 2 tool was used to construct a risk-of-bias map. R 4.3.2 and JAGS 4.3.1 were used to conduct the NMA. The Confidence in NMA web application was used to assess the quality of evidence.</div></div><div><h3>Results</h3><div>The NMA analyzed 26 studies involving 3,076 participants. For flatulence, acupoint sticking therapy was ranked first (i.e., most effective), with a surface under the cumulative ranking curve (SUCRA) of 83.2 %, and low to very low certainty. Manual acupuncture was ranked first for acid reflux (SUCRA 87.19 %, low to very low certainty) and appetite disorder (SUCRA 67.5 %, moderate to very low certainty). Warm acupuncture plus traditional Chinese medicine was ranked first for stomachache (SUCRA 75.0 %, low to very low certainty), while western medicine was ranked first for hiccups (SUCRA 91.93 %, very low certainty). There were no significant differences in efficacy between many acupuncture therapies.</div></div><div><h3>Conclusion</h3><div>Patients with AG with flatulence may benefit from acupoint sticking therapy, while the symptoms of acid reflux or appetite disorder may be relieved through manual acupuncture. However, clinical decision-making should be combined with practical factors due to the limited number of significant differences in the efficacy of various acupuncture therapies.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102572"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of aromatherapy on stress, anxiety, fatigue, and sleep quality among frontline hospital nurses: A systematic review and meta-analysis","authors":"Linfang Xu ,&nbsp;Yanan Deng ,&nbsp;Lan Zeng ,&nbsp;Ruben Martin-Payo ,&nbsp;Wei Peng ,&nbsp;Chen Qiu ,&nbsp;Keqi Chen ,&nbsp;Fengying Zhang","doi":"10.1016/j.eujim.2025.102577","DOIUrl":"10.1016/j.eujim.2025.102577","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurses experience a range of occupational stressors, including night shifts and excessive workloads. These factors significantly increase the likelihood of nurses developing chronic stress, anxiety, fatigue, and sleep disorders. Although numerous studies have proposed aromatherapy interventions as potential strategies to alleviate these health concerns, the evidence regarding their effectiveness remains inconclusive. This study aims to evaluate the effectiveness of aromatherapy on stress, anxiety, fatigue, and sleep disorders among nurses, and identify key factors for effective programs.</div></div><div><h3>Methods</h3><div>We systematically searched six electronic databases, supplemented by manual searches of Google Scholar and reference lists. The search covered the period from the inception of each database up until March 2025. Two researchers independently performed study selection and data extraction. The risk of bias of the included studies was evaluated using the RoB 2.0 tool. The quality of evidence for each outcome was graded using the GRADE framework. A random-effects model was used to perform the meta-analysis. Subgroup analysis was conducted to identify potential moderating variables.</div></div><div><h3>Results</h3><div>A total of 19 studies were included in this systematic review, 12 of which were RCTs. Meta-analysis results indicated that aromatherapy significantly alleviated stress (SMD= -0.74, 95 % CI [-1.12, -0.35], <em>Z</em> = 3.76, <em>P</em> = 0.0002) and fatigue symptoms (SMD = -0.76, 95 % CI [-1.10, -0.42], <em>P</em> &lt; 0.0001) among nurses. Short-term interventions (≤1 week) produced a larger effect size (SMD =-0.80, 95 % CI [-1.47, -0.14], <em>P</em> = 0.02) than longer-term interventions (&gt;1 week) (SMD= -0.61, 95 % CI [-0.95, -0.26], <em>P</em> = 0.0006), possibly due to olfactory adaptation or metabolic regulation. In contrast, the overall effect on anxiety reduction was not statistically significant (SMD =-0.89, 95 % CI [-2.21, 0.42], <em>P</em> = 0.18), and evidence regarding sleep quality improvement remained inconclusive.</div></div><div><h3>Conclusion</h3><div>Aromatherapy effectively reduces stress and fatigue in nurses, making it a valuable addition to workplace wellness programs.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102577"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yoga for weight management in women with polycystic ovary syndrome: A focus group study among yoga therapists","authors":"Vibhuti Samarth Rao ,&nbsp;Birinder S Cheema ,&nbsp;Mike Armour ,&nbsp;Caroline A Smith ,&nbsp;Kashinath G Metri ,&nbsp;Carolyn Ee","doi":"10.1016/j.eujim.2025.102569","DOIUrl":"10.1016/j.eujim.2025.102569","url":null,"abstract":"<div><h3>Introduction</h3><div>Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age and is associated with excess weight. Yoga is a holistic mind-body practice that has shown some promise in targeting clinical outcomes in women with PCOS. This study aimed to understand the yoga therapists’ experiences and explore the characteristics of a yoga therapy (YT) program for weight management in women with Polycystic Ovary Syndrome (PCOS) to assist in a future trial.</div></div><div><h3>Methods</h3><div>Experienced yoga therapists with a degree in yoga, or equivalent, and &gt;5 years of experience in delivering yoga to women with PCOS were invited to an online focus group. Discussions were audio-recorded, transcribed verbatim and analysed using descriptive content analysis.</div></div><div><h3>Results</h3><div>Eight yoga therapists participated. Four categories with several sub-categories were derived from the analysis: (i) yogic approach to PCOS management, (ii) benefits are beyond weight reduction, (iii) characteristics of yoga therapists, and (iv) characteristics of the YT program for managing weight in PCOS. Most participants believe that YT for PCOS should not be constructed as an exclusive form of exercise but as a mind-body intervention that focuses on lifestyle reforms, helps manage day-to-day stress, and promotes sleep and quality of life in women with PCOS. Overall, the participants indicated that a meticulously planned group-based, multicomponent, PCOS-specific, YT class can be a sustainable mode of healthy living for women with PCOS.</div></div><div><h3>Conclusion</h3><div>This is the first qualitative exploration from yoga therapists’ perspectives on weight management in women with PCOS. The results of this study provide a valuable preliminary basis for the design of future research in order to enhance lifestyle care for women with PCOS and excess weight.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102569"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Zhangyanming tablet treating dry eye disease: A prospective, open-label, randomized controlled trial","authors":"Hong-bin Xie ,&nbsp;Yuan Zhang ,&nbsp;Jun-hong Guo ,&nbsp;Ming-min Yang ,&nbsp;Jia-jia Hu ,&nbsp;Jie-wen Zhou ,&nbsp;Da-hui Ma","doi":"10.1016/j.eujim.2025.102574","DOIUrl":"10.1016/j.eujim.2025.102574","url":null,"abstract":"<div><h3>Introduction</h3><div>Dry eye disease (DED) is a chronic ocular surface disease that seriously affects quality of life. Traditional Chinese medicine (TCM) has prominent advantages in the treatment of DED. This study investigated the efficacy and safety of Chinese medicine Zhangyanming tablets (ZYMT) combined with fluorometholone eye drops (FED) and human epidermal growth factor eye drops (HEGFED) in the treatment of DED.</div></div><div><h3>Methods</h3><div>This was a randomized controlled study. A total of 122 patients with DED were randomly divided into the intervention group (<em>n</em> = 61) and the control group (<em>n</em> = 61). The control group received FED and HEGFED treatment (one drop twice daily), while the intervention group was given ZYMT (0.84 g orally, three times daily) in addition to the control group’s treatment. Both groups underwent 8 weeks of treatment. The primary outcome was the efficacy rate. The secondary outcomes included the mean change from baseline in the OSDI score and its subscales, tear film breakup time (BUT) and Schirmer’s test.</div></div><div><h3>Results</h3><div>After 8 weeks of treatment, the efficacy rate was 75.9 % (44/58) in the intervention group versus 54.2 % (32/59) in the control group (absolute difference 21.6 %, 95 % CI, 4.3 %∼37.2 %; risk ratio 1.40). The mean change from baseline in the OSDI score in the intervention group were significantly greater than those in the control group in week 8 (absolute difference -6.25, 95 % CI, -9.08∼-3.42). The mean changes from baseline in BUT, Schirmer’s test were significantly greater in the intervention group than that of the control group in both week 4 (BUT: absolute difference 2.49 s, 95 % CI, 1.82∼3.15 s; Schirmer’s test: absolute difference 1.11 mm/5 min, 95 % CI, 0.28∼1.95 mm/5 min) and week 8 (BUT: absolute difference 2.93 s, 95 % CI, 2.37∼3.49 s; Schirmer’s test: absolute difference 4.36 mm/5 min, 95 % CI, 3.88∼4.84 mm/5 min). No significant difference was observed in the safety profiles in these two groups (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Compared to using FED and HEGFED alone, combined intervention of ZYMT can effectively ameliorate the eye symptoms of DED patients, and improve the efficacy rate.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102574"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of traditional east asian herbal medicine decoctions on low back pain: A systematic review and meta-analysis","authors":"Gyu Chan Shim ,&nbsp;Sook-Hyun Lee ,&nbsp;Yoon Jae Lee ,&nbsp;Su Won Lee ,&nbsp;In-Hyuk Ha","doi":"10.1016/j.eujim.2025.102555","DOIUrl":"10.1016/j.eujim.2025.102555","url":null,"abstract":"<div><h3>Introduction</h3><div>Low back pain (LBP) is a major cause of disability and economic burden. Herbal medicine (HM) decoctions, a core component of Traditional East Asian Medicine (TEAM), are gaining attention for their potential benefits. This systematic review evaluated HM decoctions for LBP.</div></div><div><h3>Methods</h3><div>The protocol was registered in PROSPERO (CRD42024599753). Eleven databases were searched for randomized controlled trials (RCTs) on HM decoctions for LBP published before July 2024. Primary outcomes were the clinical improvement rate (CIR) and visual analogue scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index and the Japanese Orthopedic Association scale. Quality assessments using the Cochrane Risk of Bias 2 tool and meta-analyses were conducted.</div></div><div><h3>Results</h3><div>Twenty-nine RCTs involving 2420 participants with LBP were included. HM decoction compared to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the CIR (risk ratio [RR] 1.16, 95 %CI: 1.05 to 1.29) and reduced VAS-pain (mean difference [MD] -0.87, 95 %CI: -1.59 to -0.14). When combined with TEAM, HM decoction improved the CIR (RR, 1.23, 95 %CI: 1.14 to 1.33) and VAS-pain (MD -1.24, 95 %CI: -1.80 to -0.67) compared to TEAM alone. The combination of HM decoction and TEAM improved the CIR (RR 1.25, 95 %CI: 1.01 to 1.55) and VAS-pain (MD -0.51, 95 %CI: -0.67 to -0.34) compared to NSAIDs alone, and a higher CIR (RR 1.30, 95 %CI: 1.12 to 1.52) than TEAM combined with NSAIDs. Combining HM decoction with NSAIDs improved the CIR (RR 1.48, 95 %CI: 1.19 to 1.85) compared to NSAIDs alone; however, there was no difference in VAS-pain (MD -1.09, 95 %CI: -2.35 to 0.17). HM decoction combined with non-pharmacological therapies (NPTs) improved the CIR (RR 1.18, 95 %CI: 1.05 to 1.32) and VAS-pain (MD -1.28, 95 %CI: -1.42 to -1.14). Finally, adding HM decoction to a regimen of NSAIDs and NPTs also improved the CIR (RR 1.24, 95 %CI: 1.09 to 1.42, but the reduction in VAS-pain was not statistically significant (MD -1.53, 95 %CI: -3.35 to -0.29).. In the seven RCTs that reported adverse events, these were absent or mild and comparable across intervention and control groups.</div></div><div><h3>Conclusion</h3><div>HM decoction demonstrated beneficial clinical effects for participants with LBP. Limitations included high risk of bias in many RCTs. Well-designed RCTs are warranted to validate effectiveness.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102555"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Qingwei Zhitong pellets combined with bismuth quadruple therapy for Helicobacter pylori eradication: A randomized controlled trial","authors":"Zhen Li ,&nbsp;Xiaolin Zhao ,&nbsp;Kun Huang ,&nbsp;Yong Cai ,&nbsp;Chanjuan Fan ,&nbsp;Dongling Xie ,&nbsp;Lili Zhai ,&nbsp;Sheng Li ,&nbsp;Xiaomei Zhang ,&nbsp;Haiou Ding ,&nbsp;Pan Wang ,&nbsp;Jianping Cheng","doi":"10.1016/j.eujim.2025.102557","DOIUrl":"10.1016/j.eujim.2025.102557","url":null,"abstract":"<div><h3>Introduction</h3><div>We previously reported that Qingwei Zhitong pellets (QZP)-containing quadruple therapy was safe and effective for <em>Helicobacter pylori</em> (<em>H. pylori</em>) eradication. However, it remains unclear whether QZP adjunctive to bismuth-based quadruple therapy (BQT) enhances <em>H. pylori</em> eradication rates and reduces adverse events. The aim of this study was to investigate the effect of adding QZP to BQT on the eradication rate of <em>H. pylori</em>.</div></div><div><h3>Methods</h3><div>In this single-center, randomized controlled trial, 336 patients were randomized 1:1:1 to receive 14-day therapy with either BQT (compound bismuth aluminate 1.3 g three times daily, rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, clarithromycin 500 mg twice daily), BQT plus QZP (3.2 g three times daily), or triple therapy (rabeprazole, amoxicillin, clarithromycin at aforementioned doses) plus QZP (3.2 g three times daily). The primary endpoint was the eradication rate of <em>H. pylori</em>. Secondary endpoints included symptom improvement, adverse effects, and treatment compliance.</div></div><div><h3>Results</h3><div>In intention-to-treat analysis, eradication rates were significantly higher with BQT-QZP (85.7 %) than with TT-QZP (73.2 %) or BQT (74.1 %) (RR 0.85, 95 % CI 0.76–0.96 and RR 0.86, 95 % CI 0.78–0.96, respectively). BQT-QZP showed superior symptom outcomes, with higher rates of complete resolution (13.4 % vs. 6.3 % and 4.5 %) and overall improvement (86.6 % vs. 63.4 % and 53.6 %). BQT-QZP also resulted in the highest total effective rate (71.4 % vs. 54.5 % and 60.7 %) and healing rate (19.6 %). The three groups demonstrated comparable rates of overall adverse events, and treatment compliance rates were high, with comparable levels between the groups.</div></div><div><h3>Conclusions</h3><div>A 14-day BQT combined with QZP quintuple therapy achieves an acceptable eradication rate as first-line anti-<em>H. pylori</em> therapy.</div></div><div><h3>Registration</h3><div>ChiCTR2300077090.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102557"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of Astragalus membranaceus-based traditional Chinese medicine in treating diabetic foot ulcers: A systematic review and meta-analysis of randomized controlled trials","authors":"Bingrui Zhang ,&nbsp;Kebin Wang ,&nbsp;Yuxiao Li ,&nbsp;Qinhua Fan ,&nbsp;Qingxiao Li ,&nbsp;Yingqiu Sun ,&nbsp;Yawei Du ,&nbsp;Wenquan Su ,&nbsp;Shengxian Wu","doi":"10.1016/j.eujim.2025.102561","DOIUrl":"10.1016/j.eujim.2025.102561","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Astragalus membranaceus</em> (AM) is a traditional Chinese medicine employed for supplementing qi and particularly used for ulcer treatment. This systematic review aimed to examine the effectiveness and safety of AM-based prescriptions (AMPs) for diabetic foot ulcer (DFU).</div></div><div><h3>Methods</h3><div>We searched eight databases to identify randomized controlled trials (RCTs) focusing on AMPs for DFU. The mean difference (MD) and relative risk (RR) with 95% confidence interval (CI) were calculated and used in the meta-analysis.</div></div><div><h3>Results</h3><div>We included 44 RCTs involving 3,238 participants. The AMPs included 24 oral AM formulas, 14 topical AM formulas, 4 topical AM alone, and 2 injections. Overall, study quality was low. Compared with Western medicine (WM), AMPs were associated with a higher healing rate (RR 1.64, 95% CI 1.4 to 1.9, 8 RCTs, n = 747), smaller ulcer size (MD –12.11 cm², 95% CI –19.23 to –4.99, 4 RCTs, n = 304) and shorter healing time (MD –7.82 days, 95% CI –10.59 to –5.05, 4 RCTs, n = 353). AMPs plus WM were more efficacious than WM in healing rate (RR 1.22, 95% CI 1.07 to 1.4, 20 RCTs, n = 1497), amputation rate (RR 0.42, 95% CI 0.27 to 0.66, 3 RCTs, n = 265), mortality (RR 0.29, 95% CI 0.12 to 0.71, 3 RCTs, n = 265), ulcer size (MD –1.78 cm², 95% CI –2.55 to –1.01, 10 RCTs, n = 761), healing time, ankle-brachial index (ABI), pain scores, clinical effective rate, and general symptoms. No severe adverse events were reported in the AMPs group.</div></div><div><h3>Conclusion</h3><div>AMPs may have potential effectiveness in ulcer healing, ABI increase, and pain alleviation. The exact efficacy of AMPs for DFU needs to be confirmed using high-quality double-blind RCTs.</div></div><div><h3>Registration</h3><div>Protocol of this review was registered via PROSPERO (CRD42024613403).</div></div><div><h3>Funding</h3><div><span>National Science and Technology Major Project of China</span> [grant number <span><span>2017ZX09304019</span></span>].</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102561"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dietary chitosan on serum lipid levels: A systematic review and meta-analysis of randomised controlled trials","authors":"Yenn Ye Yap ,&nbsp;Zoriah Aziz","doi":"10.1016/j.eujim.2025.102578","DOIUrl":"10.1016/j.eujim.2025.102578","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypercholesterolaemia is a key risk factor for cardiovascular diseases. Although chitosan is known for its weight loss properties, its effects on serum lipid levels remain unclear. This study aimed to evaluate the effects of dietary chitosan on serum lipid levels, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and total cholesterol (TC).</div></div><div><h3>Methods</h3><div>A comprehensive search of electronic databases including Medline, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Complete was conducted. Randomised controlled trials (RCTs) were eligible if they assessed the effects of chitosan on LDL-C, HDL-C, TG, and TC in patients with hypercholesterolaemia or dyslipidaemia at baseline. We assessed the risk of bias of included studies, pooled the results using a random-effects model, and evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.</div></div><div><h3>Results</h3><div>We included 16 RCTs involving a total of 1327 participants. The meta-analysis showed chitosan was associated with statistically significant reduction of LDL-C (WMD: -0.16 mmol/L, 95% CI: -0.23 to -0.10), TG (WMD: -0.04 mmol/L, 95% CI: -0.08 to -0.01), and TC (WMD: -0.25 mmol/L, 95% CI: -0.36 to -0.14), while the effect on HDL-C was not statistically significant (WMD: 0.01 mmol/L, 95% CI: -0.02 to 0.04). Adverse events, mainly mild gastrointestinal (GI) symptoms, were reported in 11 of 16 studies, with constipation being the most common. Subgroup analyses indicated variations in treatment effects based on chitosan dosage, and sensitivity analysis revealed that the TG-lowering effect of chitosan was statistically unstable.</div></div><div><h3>Conclusion</h3><div>Chitosan is associated with statistically significant but clinically negligible reductions in LDL-C, TG, and TC, and has no meaningful effect on HDL-C. The overall certainty of evidence was moderate for LDL-C and low for HDL-C, TG, and TC. Better-designed, larger, and longer trials are needed to confirm its safety and effectiveness as a lipid-lowering supplement.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102578"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the demands for home-based healthcare services using traditional Korean medicine in older adults and individuals with disabilities: A mixed methods study","authors":"Soo-Hyun Sung ,&nbsp;Kyeong-Han Kim ,&nbsp;Hyein Jeong ,&nbsp;Soobin Jang","doi":"10.1016/j.eujim.2025.102568","DOIUrl":"10.1016/j.eujim.2025.102568","url":null,"abstract":"<div><h3>Introduction</h3><div>Many older adults and individuals with disabilities experience significant barriers to accessing clinic-based health services, often resulting in unmanaged chronic conditions and diminished quality of life. Home-based healthcare is emerging as a viable solution, and interest in traditional Korean medicine is increasing due to its accessibility and perceived safety. This study aimed to identify the needs and expectations of older adults and individuals with disabilities for home-based healthcare using traditional Korean medicine.</div></div><div><h3>Methods</h3><div>Our study employed a mixed methods design that combined survey data and qualitative research. The online survey was conducted among two groups: 1) older adults aged 65 years and older and 2) individuals with disabilities aged 20 years and older. Semi-structured focus group interviews were conducted for the respondents who received home visits from traditional Korean medicine doctors</div></div><div><h3>Results</h3><div>Survey findings revealed that older adults showed a higher demand and willingness to participate in home-based healthcare services than individuals with disabilities. Respondents identified chronic conditions such as hypertension, diabetes, stroke, and dementia as key targets for home-based care. High-priority needs included physical and mental health support, health monitoring, and integration with conventional medical services. The most valued benefit of home-based care was improved accessibility for those with difficulty visiting hospitals. Focus group interview participants, particularly older adults, described feeling psychologically supported and satisfied through extended health counseling provided during house calls. Individuals with disabilities emphasized the need for transportation support for follow-up hospital visits.</div></div><div><h3>Conclusions</h3><div>Our findings provide foundational evidence for the development of integrated, home-based healthcare policies targeting older adults and people with disabilities. Expanding home-based traditional Korean medicine care may address health inequities and enhance well-being among populations with limited mobility.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102568"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}