Forschende Komplementarmedizin最新文献

{"title":"[Welcome to phytotherapy].","authors":"Beat Meier","doi":"10.1159/000363713","DOIUrl":"https://doi.org/10.1159/000363713","url":null,"abstract":"Die Organisatoren der dritten gemeinsamen Phytotherapie-Tagung der Gesellschaften für Phytotherapie aus den mehrheitlich deutschsprachigen Ländern Deutschland, Österreich und der Schweiz freuen sich im Verbund mit den Mitorganisatoren der Gesellschaft für Arzneipflanzenforschung und der European Scientific Cooperative on Phytotherapy (ESCOP) sowie den mitarbeitenden Instituten diesen Tagungsband, der zugleich auch das Programmheft ist, vorlegen zu können. Es ist, unseres Wissens, das erste Mal, dass ein Phytotherapiekongress in einem solchen Tagungsband umfassend dokumentiert wird. Wir möchten an dieser Stelle allen Referierenden, den Autoren der Poster und dem S. Karger-Verlag für ihre Arbeit danken. Ziel der Veranstaltung und dieses Supplements ist es, die Phytotherapie und ihr Potential bekannter zu machen. Standen bei früheren Tagungen die pflanzlichen Arzneimittel im Fokus, so richtet sich diesmal das Interesse auf die Therapie, die in der Geriatrie ein großes Potential hat. Die Phytotherapie versteht sich als Bestandteil einer modernen Medizin, die über die reine Medikation hinausgeht und in umfassenden, oft individuellen Therapiekonzepten ihren Platz hat. Ein weiteres Anliegen der Tagung ist es, über die Zukunft der Phytotherapie zu diskutieren. Für eine Zukunftsperspektive der Phytotherapie braucht es Forschung. Der Wirksamkeitsnachweis unterliegt immer zeitbedingten Limitierungen und oft auch Fixationen. Neue Forschungsstrategien werden der Phytotherapie eher gerecht und müssen eingesetzt sowie gefördert werden. Meta-Analysen und Versorgungsforschung werden respektive sind schon wichtige Instrumente für den Nachweis von Wirksamkeit, Zweckmäßigkeit und Wirtschaftlichkeit von Therapien. Für deren Anerkennung gilt es, sich einzusetzen. Die Zukunft fordert auch die Behörden: Wege müssen gefunden werden, die es wieder attraktiv erscheinen lassen, pflanzliche Arzneimittel zur Zulassung zu bringen. Die Hürden und damit die Kosten sind in den letzten Jahren zu hoch geworden. Das Potential der neuen HMPC-Monographien wurde wohl deshalb bisher nur sehr ungenügend genutzt. Dies obwohl die Bereitschaft, pflanzliche Arzneimittel zuzulassen, in den deutschsprachigen Ländern nach wie vor groß und in Europa in den letzten Jahren dank der Etablierung des Herbal Medicinal Product Committees (HMPC) bei der European Medical Agency (EMA) verankert worden ist. Schließlich soll die Phytotherapie auch in der Veterinärmedizin wieder eine Zukunft haben. Anders als in der Humanmedizin ist die Phytotherapie in diesem Bereich aus dem Arzneimittelschatz fast vollständig verschwunden, so dass mit Felduntersuchungen und historischen Arbeiten versucht werden muss, altbekannte Therapieerfahrungen wieder zugänglich zu machen. Die 64 Poster ergeben ein umfangreiches Bild zur Forschung, die neben pharmaziehistorischen Aspekten die Qualität und Zusammensetzung, die Pharmakologie, die Therapie, die Sicherheit und die Zulassung pflanzlicher Arzneimittel zum Thema haben. Eine b","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 Suppl 1 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000363713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32494542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing a computer-assisted, digital tongue-imaging device for standardization of traditional tongue diagnosis.","authors":"Isabel Gareus,&nbsp;Thomas Rampp,&nbsp;Linda Tan,&nbsp;Rainer Lüdtke,&nbsp;Corinna Niggemeier,&nbsp;Romy Lauche,&nbsp;Petra Klose,&nbsp;Gustav Dobos","doi":"10.1159/000365019","DOIUrl":"https://doi.org/10.1159/000365019","url":null,"abstract":"<p><strong>Background: </strong>In Traditional Chinese Medicine (TCM) tongue diagnosis and pulse diagnosis are the major diagnostic methods up till now. As western research has tended to focus on acupuncture, attempts to standardize the classic diagnostic methods have been few.</p><p><strong>Methods: </strong>A digital camera with a ring flash was fixed in a frame, so that the tongue-lens-distance and illumination were kept constant. A pilot study testing the inter-methods reliability, test-retest reliability, and interrater reliability of 2 observers was conducted: the tongues (1 ×) as well as the tongue images (2 ×) from 76 patients from our ward were assessed with a standardized rating list in a randomized order by both observers, who were mutually blinded. As primary outcome measure we used agreement beyond chance (Cohen's kappa).</p><p><strong>Results: </strong>The colors of the tongue body / the tongue coating were the main criteria for the authentic reproduction of the tongue in our images. Inter-methods reliability for the color of the tongue body/coating was kappa 0.35 / 0.34 (p < 0.001) for observer 1 and 0.59 / 0.57 (p < 0.001) for observer 2. Test-retest reliability for the color of the tongue body / the tongue coating was kappa 0.53 / 0.48 (p< 0.001) for observer 1 and 0.65 / 0.62 (p < 0.001) for observer 2. Interrater reliability was generally low.</p><p><strong>Conclusions: </strong>The introduced device represents a first step towards standardization of tongue diagnosis. However, inter-methods as well as test-retest reliability vary between observers and different morphological characteristics.</p>","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 3","pages":"190-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000365019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32531886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Personalized medicine - the wheel has been reinvented].","authors":"Karin Kraft","doi":"10.1159/000365098","DOIUrl":"https://doi.org/10.1159/000365098","url":null,"abstract":"Die personalisierte Medizin ist seit einigen Jahren eines der wichtigsten aktuellen Forschungsthemen der westlichen Medizin. Wahrend die Entwicklung von individuellen tumorspezifischen Therapien einschlieslich begleitender diagnostischer Gentests und noch umfassenderer «omics»-basierter Versuche, Diagnostik und Therapie zu personalisieren, standig vorangetrieben wird, stehen neuerdings auch andere Aspekte wie z. B. die Verlangerung der beschwerdefreien Lebensspanne im Alter durch personalisierte Medizin im Fokus. Hintergrund ist die recht neue Erkenntnis, dass es in jeder Hinsicht lohnender ware, den Prozess des Alterns (Seneszenz) selbst zu verlangsamen, um eine verlangerte gesunde Lebensspanne bis zum zehnten Lebensjahrzehnt und infolgedessen eine Kompression der Periode der altersassoziierten Erkrankungen zu erreichen, als diese Krankheiten selbst zu eliminieren. Dadurch wurde sich die Lebensspanne nur um wenige Jahre verlangern [1]. Dieses Vorgehen scheint ubrigens auch eine der wenigen Moglichkeiten zu sein, die derzeit explodierenden Kosten im Gesundheitswesen in vorhersehbarer Weise zu senken, denn die kostenintensive Phase der Multimorbiditat wurde damit auf eine relativ kurze Zeitspanne im sehr hohen Alter verlegt. Jedenfalls wurde in der Arbeit von Goldman et al. [1] in einer Modellrechnung fur altere US-Amerikaner ermittelt, dass eine Verzogerung der Seneszenz die Lebenserwartung um zusatzliche 2,2 Jahre steigern konnte, die vorwiegend bei guter Gesundheit verbracht wurden. Der okonomische Nutzen wurde – bei entsprechender Anhebung des Rentenalters – auf 7,1 Billionen USD fur die nachsten 50 Jahre geschatzt. Im Gegensatz dazu wurden die gegenwartig ublichen, eher reparaturorientierten Strategien, die auf die separate Bekampfung von kardiovaskularen und neurodegenerativen Erkrankungen sowie Krebs gerichtet sind, zu einer Abnahme der Fortschritte bei Gesundheit und Langlebigkeit fuhren, insbesondere wegen kompetitiver Risiken. Hier ware die Adaptation fur die Anwendung in einer hochaltrigen Patientenpopulation erforderlich. Die Altersforschung der personalisierten Medizin wird zukunftig auf 3 Saulen basieren: 1. Ausbau des auf den bisherigen Kohortenstudien basierenden Wissens, wobei wegen der erforderlichen Differenzierung und Klassifikation der Patienten innerhalb einer Kohorte, z.B. entsprechend ihres Genotyps, sehr hohe Fallzahlen erforderlich sind und eine Studiendauer uber Jahrzehnte notwendig ist. 2. Vergleichbare Studien bei geeigneten Tiermodellen, die den Vorteil haben, in wesentlich kurzeren Zeitraumen Ergebnisse zu erzielen. 3. Gezielte Untersuchungen zur Biologie des Alterns bei Mensch und Tier, um die Bedeutung von Biomarkern und den Wert von Interventionen abschatzen zu konnen. Dies schliest die Wirkungen von Genotyp und Umwelt und die Wirkungen der Interaktion zwischen verschiedenen Mechanismen sowie der Kombination von Interventionen ein. Dafur wird ein sehr hoher Einsatz von Forschungsmitteln erforderlich sein, der auch","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 3","pages":"152-3"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000365098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32532451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Problems in integrative postgraduate medical training of physicians at anthroposophic hospitals in Germany and Switzerland].","authors":"Peter Heusser,&nbsp;Sabine Eberhard,&nbsp;Johannes Weinzirl,&nbsp;Pascale Orlow,&nbsp;Bettina Berger","doi":"10.1159/000366187","DOIUrl":"https://doi.org/10.1159/000366187","url":null,"abstract":"<p><strong>Background: </strong>Anthroposophic hospitals provide integrative medical care by complementing conventional (CON) with anthroposophic medicine (AM). They teach integrative medicine in postgraduate medical training (PGMT). In a first evaluation of PGMT quality in AM, we analyzed the problems of this training from the perspectives of trainers and trainees.</p><p><strong>Method: </strong>We conducted an anonymous cross-sectional full survey of all trainee and trainer physicians at the 15 AM hospitals in Germany (DE) and Switzerland (CH) with questionnaires of the Swiss Institute of Technology (ETH) Zürich, complemented by a module for AM. We also conducted descriptive statistics for questions with answering scales as well as calculations of group differences (two-tailed Mann-Whitney U test) and a qualitative content analysis (Mayring) of free text answers related to the problem analysis.</p><p><strong>Results: </strong>The response rate in DE embraced 89 out of 215 (41.39%) surveyed trainees and 78 out of 184 (42.39%) trainers; in CH, the response rate comprised 19 out of 25 (76%) trainees and 22 out of 30 (73.33%) trainers. Free text answers related to problem analysis in DE and CH were given by 16 out of 108 (14.8%) trainees and by 20 out of 100 (20%) trainers, overall. Perceived main problems include work overload; shortcomings in work organization; delimitation of competences; interprofessional cooperation; financial resources (trainers); wages (trainees DE); practical relevance of AM (trainees and trainers in DE); professional or didactic competence of trainers; lack of interest in AM (trainees); problems with learning and practicing AM; no curriculum for postgraduate medical training in AM; tensions between AM and CON. Explanations for the differences between DE and CH include larger departments and the DRG system in DE, but also better structural conditions for AM PGMT in CH.</p><p><strong>Conclusion: </strong>Main problems of PGMT in AM include not only non-specific and systemic aspects, but also AM-specific issues. In order to develop a basis for concrete problem solving options, this study will be complemented by an analysis of solution ideas from the perspective of the involved trainers and trainees.</p>","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 4","pages":"223-30"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000366187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32676894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Glycyrrhiza glabra L. reduce delirium after coronary artery bypass graft surgery?","authors":"Abolfazl Firouzian,&nbsp;Hadi Darvishi Khezri","doi":"10.1159/000370035","DOIUrl":"https://doi.org/10.1159/000370035","url":null,"abstract":"Hadi Darvishi Khezri, MSc Thalassemia Research Center Hemoglobinopathy Institute, Booali Sina Hospital Pasdaran Boulevard, Sari, Iran Hadidarvishi87@yahoo.com © 2014 S. Karger AG, Freiburg 1661–4119/14/0216–0418$39.50/0 Coronary artery bypass graft (CABG) surgery is one of the most commonly performed invasive procedures worldwide [1, 2]. Since the introduction of cardiopulmonary bypass (CPB), the neurological consequence of CABG surgery has been an important subject [2]. Delirium is a major problem after CABG surgery with the approximate reported incidence rate of 20–80% [2]. This complication is associated with increased mortality, longer hospital stay, increased hospital costs, and long-term care [2–4]. Regarding the high incidence of delirium in patients undergoing CABG surgery, prophylactic treatment is preferable. Hence, pharmacological neuroprotective strategies have been developed for these patients [3, 4]. A meta-analysis indicated that preoperative low-dose and shortterm administration of haloperidol or risperidone may modestly reduce delirium occurrence in high-risk patients that need intensive care unit (ICU) [4]. Other clinical trials have not reported any decreases in the incidence rate of delirium in patients receiving pharmacologic prophylactic (haloperidol, donepezil [5], citicoline [6], and rivastigmine) [7–9]. Acute inflammation and reduced serotonin neurotransmitter are the most important causes of delirium in these patients [10, 11]. In a meta-analysis, Peng et al. [12] showed the role of peripheral inflammatory markers, such as interleukin-6 and S-100 , in postoperative delirium [13]. Although some studies indicated that use of compounds with brain protective activities (such as propofol, aprotininand lidocaine) can prevent delirium after CABG surgery, no sufficient evidence was presented to make a change in standard clinical practice. Licorice (G. glabra, species: Leguminosae) is a worldwide popular herbal medicine. Just 3 out of the numerous species of licorice are usually used as commercial drugs, including G. glabra, Glycyrrhiza echinata L., and Glycyrrhiza uralensis Fisch. In traditional medicine, the roots and rhizomes (underground stems) of licorice are currently used as therapeutic compounds in many Asian and European countries. Licorice mainly consists of a mixture of glycyrrhizinic acid, glycyrrhizic acid, glycyrrhizin, isoflavones, isoliquiritigenin, hispaglabridin B, paratocarpin B, and glabiridin. Furthermore, this plant has been used as antidote and demulcent, expectorant, antioxidant, antiulcer, laxative, antipyretic, antimicrobial, and antiinflammation agent [14]. Glabridin, a major active flavonoid in licorice, has anti-atherosclerotic, anti-inflammatory, antinephritis, radical scavenging activities and antidepressant-like effects [15]. Moreover, this compound has been reported to be useful for renovascular and cardiovascular diseases [16]. Ojha et al. [16] evaluated the cardioprotective effect of licorice ag","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 6","pages":"418-9"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000370035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32979048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The use of complementary and alternative therapies in Germany - a systematic review of nationwide surveys].","authors":"Klaus Linde, Anna Alscher, Clara Friedrichs, Stefanie Joos, Antonius Schneider","doi":"10.1159/000360917","DOIUrl":"10.1159/000360917","url":null,"abstract":"<p><p>In this systematic review we aimed to summarize surveys investigating the use of complementary and alternative medicine (CAM) methods in the general German population and by physicians and lay practitioners. Nationwide surveys (using random, panel, or quota sampling methods) published since 1993 investigating the CAM use among the population and healthcare providers in Germany were identified through searches in PubMed, Google Scholar, Google, citation screening, and expert contacts. In addition we collected publicly available data from official nationwide health statistics and market statistics. 16 surveys of the general adult population and 4 surveys among physicians met inclusion criteria. The use of CAM among general population in the previous years varied between 40 and 62%. General practitioners and orthopedic specialists in private practice seem to provide CAM therapies widely and more frequently than other physician groups, with herbal medicine and chirotherapy being the most frequently used treatments. We could not identify any surveys of lay practitioners. The available surveys provide clear evidence of the widespread use of CAM methods in Germany both by the general population and by physicians. In recent years the use of CAM methods does not seem to increase any longer; for some methods (particularly herbal remedies) the use seems to be declining.</p>","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 2","pages":"111-8"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32359310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phytotherapy - new developments and insights into practice.","authors":"Karin Kraft,&nbsp;Jost Langhorst","doi":"10.1159/000370020","DOIUrl":"https://doi.org/10.1159/000370020","url":null,"abstract":"ment of the EMA, is pending in the EU as well. The authorization problem results from the required evidence-based efficacy proof that causes costs in the range of EUR 30,000 up to EUR 1 Million for each product. However, in Switzerland and in the EU, the manufacturers of herbal medicinal drugs usually have limited financial resources. Dr. Wenng suggested that the lacking money could be raised by crowdfunding and pointed out that it is about time for European decision-makers to appreciate the benefit of European medicinal herbal products, such as low price, low cost in manufacturing, less drug-related side effects, and the still underachieved potential of natural resources of planet earth. This is even more urgent as many authorized herbal products are no longer available on the European market due to financial problems. We believe that the present edition of FORSCHENDE","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 6","pages":"345-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000370020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32978561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post CAMbrella--before CAMbrella 2.0? Where do we stand in the European CAM networking?","authors":"Bettina Reiter","doi":"10.1159/000366247","DOIUrl":"https://doi.org/10.1159/000366247","url":null,"abstract":"","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 4","pages":"220-1"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000366247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32676442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of insomnia in traditional Persian medicine.","authors":"Peyman Petramfar,&nbsp;Mohammad M Zarshenas,&nbsp;Mahmoodreza Moein,&nbsp;Abdolali Mohagheghzadeh","doi":"10.1159/000360910","DOIUrl":"https://doi.org/10.1159/000360910","url":null,"abstract":"<p><p>Insomnia is a sleep disorder which affects 10-48% of general population. Different measures, such as pharmacotherapy and behavioral management, are applied for insomnia and associated complaints. In traditional medical systems, herbal medicines are considered beneficial. Therefore, the present paper compiles pharmacological and medical insights into the management of insomnia according to Traditional Persian Medicine. Herein, preserved medical and pharmaceutical manuscripts of Persian medicine from 10th to 18th century A.D. were investigated for information about concepts of insomnia treatment and herbal remedies. Additionally, for all herbal remedies, an extensive search of scientific databases, such as MEDLINE and Scopus, has been performed to find related works concerning hypnotic, sedative, and anxiolytic as well as narcoleptic effects. Insomnia (generally called Sahar in Persian manuscripts) is a well-known disorder. Herbal medical intervention was the major treatment prescribed by Iranian physicians. Totally, 36 medicinal herbs related to 25 plant families are derived from the searched literature. These remedies were applied orally, topically, and nasally. Based on scientific data, 50% of reported herbs have relevant pharmacological effects. Besides historical elucidation, this paper presents medical and pharmacological approaches that had been applied by Persian practitioners in order to deal with sleep complications. Considering the fruitful results of these findings, this essay should encourage researchers to conduct more investigations in this field in order to understand the mechanisms and effects of traditionally applied herbs still unknown to modern medicine.</p>","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 2","pages":"119-25"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000360910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32359311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Complementary, alternative and integrative therapies in medical guidelines - the guideline \"Diagnosis and treatment of ulcerative colitis\" as an example of successful integration].","authors":"Holger Cramer,&nbsp;Romy Lauche,&nbsp;Petra Klose,&nbsp;Gustav Dobos,&nbsp;Jost Langhorst","doi":"10.1159/000358577","DOIUrl":"https://doi.org/10.1159/000358577","url":null,"abstract":"Die aktuelle Leitlinie «Diagnostik und Therapie der Colitis ulcerosa» wurde im September 2011 unter Federfuhrung der Deutschen Gesellschaft fur Verdauungsund Stoffwechselkrankheiten (DGVS) und Mitarbeit der Deutschen Gesellschaft fur Pathologie (DGP), der Deutschen Gesellschaft fur Allgemeinund Viszeralchirurgie (DGVC), der Gesellschaft fur padiatrische Gastroenterologie und Ernahrung (GPGE) sowie der Deutschen Gesellschaft fur Ernahrungsmedizin (DGEM) vorgelegt. Die nachste Aktualisierung ist fur September 2016 avisiert; die gegebenen Empfehlungen werden also noch eine geraume Weile den Goldstandard in der Therapie der Colitis ulcerosa darstellen [1]. Fur eine Reihe komplementarmedizinischer Verfahren enthielt die Leitlinie evidenzbasierte positive Empfehlungen, die einen hinreichenden Konsens in der Leitlinienkonferenz fanden (Tab. 1). So wurden abgeschwacht positive Empfehlungen fur das Phytotherapeutikum Plantago ovata gegeben, das sich in einer klinischen Studie Mesalazin in der remissionserhaltenden Behandlung als ebenburtig erwies (Empfehlung 10.16); ebenso fur Curcumin, das in der remissionserhaltenden Behandlung komplementar zu 5-ASA empfohlen wird (Empfehlung 10.15). Ein Problem in der Anwendung von Curcumin in Deutschland ergibt sich allerdings daraus, dass in der japanischen Studie [2], auf der die Empfehlung beruht, Curcumin in einer Dosis von 2 × 1 g/Tag eingesetzt wurde, wahrend die in Deutschland verfugbaren Praparate deutlich geringere Dosierungen enthalten. Daneben gibt die Leitlinie eine abgeschwacht positive Empfehlung fur Akupunktur in Kombination mit Moxibustion als komplementare Therapie im leichten bis moderaten Schub (Empfehlung 10.18) sowie fur eine multimodale komplementare Mind-Body-Therapie zur Verbesserung der Lebensqualitat (Empfehlung 10.17). Letztere Empfehlung ist bisher nahezu einzigartig in Deutschland; erstmals wird hier eine multimodale MindBody-Therapie empfohlen, wie sie in Deutschland in integrativmedizinischen Kliniken angeboten wird [3]. Die Empfehlung basiert unter anderem auf einer deutschen randomisierten Studie [4, 5], die zeigen konnte, dass ein multimodales Lebensstilmodifikationsprogramm mit Elementen der Mind-Body-Medizin die Lebensqualitat von Patienten in Remission oder mit geringer Krankheitsaktivitat in klinisch relevantem Umfang steigern kann. Weitere komplementarmedizinische Verfahren, inklusive weiterer Phytotherapeutika und einzelner Verfahren der Mind-Body-Medizin wie Yoga oder Qigong, konnten aufgrund der unzureichenden Datenlage nicht empfohlen werden (Empfehlung 10.20). Ein potenzieller Kandidat fur zukunftige Aktualisierungen der Leitlinie scheint die Behandlung mit Eiern des Schweinepeitschenbandwurms (Trichuris suis ovata) zu sein, die in einer randomisierten Studie im leichten bis moderaten Schub die Krankheitsaktivitat signifikant starker senken konnte als Placebo, derzeit aber – vor dem Hintergrund der fehlenden Zulassung in Deutschland – nicht generell empfohlen wird (Empfehlun","PeriodicalId":51049,"journal":{"name":"Forschende Komplementarmedizin","volume":"21 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000358577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40289825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}