An increasing recognition of traditional, complementary and integrative medicines' (TCIM) contributions for public health has driven the development of international policy recommendations for its inclusion into national healthcare systems. While many countries have made advances in the incorporation of TCIM in academic medicine, there are globally only a handful that have a constitutional mandate in this context. The present cross-sectional study focused on one of these, namely Switzerland, some fifteen years after TCIM was included into the country's Federal Constitution. This research aimed to examine attitudes of the future medical workforce in regard to TCIM within the only European country in which TCIM is mandated by the constitution. More specifically, using an online survey tailored to the country's socio-political context, this study assessed attitudes, knowledge, and expectancies regarding TCIM among medical students across all Swiss universities that offer degrees in human medicine. Even though Swiss medical schools have consolidated and expanded their TCIM-related curricula compared to earlier assessments, with all of them now offering mandatory TCIM classes, most participants were unaware of this. Nonetheless, two-thirds of the N = 695 participants considered TCIM a valuable extension of conventional medicine that should have a place in medical education. Views diverged greatly between TCIM modalities. Further, we found significant differences as a function of gender and linguistic regions, although in the latter case effect sizes were modest. Knowing the views of medical students as the future generation of physicians, clinical scientists, and often also decision-makers in the context of policy-driven integration is crucial in understanding the future trajectory of TCIM into mainstream healthcare. Based on Switzerland's unique experience and history in this context this work contributes to the broader discourse on the role of TCIM in national healthcare systems.
Traditional health practitioners (THP) and complementary and alternative medicines (CAM) play a well-recognized role in Africa. However, their role in treating movement disorders (MD) remains poorly studied. This large multicenter continental study aimed to investigate the prevalence of seeking and consulting THPs and using CAMs among people with MDs in different African countries and the associated factors of their use. This study involved 12 sites within 11 African countries. We developed and distributed a structured questionnaire that documented frequency, attitudes, beliefs, and factors related to patients' engagement with THPs and use of CAMs. We surveyed 1158 participants with MDs from 11 African countries in different regions of the continent. Overall engagement with THP and CAM use were reported in about a third (319 [27.5%] and 356 [30.7%], respectively) of individuals with MDs, which was associated with delayed diagnosis and medical treatment initiation and significantly varied by country, reaching up to 80%, particularly among individuals from sub-Saharan Africa (SSA) and those with hyperkinetic MDs. Common contributing factors included unavailability, unaffordability, and lack of access to health services; misconceptions regarding disease nature; lack of curative response to medications; feeling of stigma; rural residence and patients' ethnicity; and levels of education and employment. These factors were more pronounced in patients in SSA. Seeking THPs and using CAM are widespread practices in African countries and have a negative impact on patients' care. Their use is related to inadequate health-care services, misconceptions, and other factors, which are modifiable and mandate immediate and comprehensive actions. © 2026 International Parkinson and Movement Disorder Society.
Using a large cross-national dataset (N ≈ 23,000), this study investigates the relationship between several aspects of online health information-seeking and the use of traditional, complementary, and integrative medicine (TCIM), as well as the belief that TCIM is better than conventional medicine in Western societies. It also examines how perceptions of the internet as a valuable tool to guide health decisions and perceived reliability of online information relate to TCIM use and beliefs about its superiority. Ordinal logistic regression models were used to assess the association between online health information-seeking behavior, perceived usefulness, and reliability of online health information, and two outcomes: TCIM use and belief in TCIM superiority over conventional medicine. Analyses were based on data from the 2021 ISSP module on Health and Healthcare, restricted to Western countries. Findings reveal a significant, graded association between more frequent online health information-seeking and both higher TCIM use and stronger belief that TCIM is better than conventional medicine. Those who perceived the internet as helpful in verifying doctors' advice or evaluating symptoms also had significantly higher odds of TCIM use and belief in its superiority. Notably, respondents expressing uncertainty about distinguishing reliable online health information showed the highest odds of TCIM use and belief in its superiority. Those agreeing it was difficult also had elevated odds, though less pronounced. This study reveals that online health information-seeking is significantly linked to TCIM adoption and belief in its superiority over conventional medicine, including among individuals who express uncertainty about the reliability of online information. We suggest that the profiles of internet-engaged complementary medicine users are not uniform and may consist of both astute seekers who make an independently informed choice to use TCIM, as well as vulnerable users, potentially overwhelmed by misinformation. This study highlights the need to integrate TCIM into institutional healthcare frameworks, develop legal standards for TCIM use, promote digital health literacy, and improve doctor-patient communication.
The widespread use of traditional, complementary and integrative medicines (traditional medicine) across the world suggests that integration of traditional medicine into the formal health system is one strategy for extending universal health coverage (UHC). To improve access to and the quality of traditional medicine services will require attention to strengthening the traditional medicine workforce. The challenges associated with making such improvements should not be underestimated due to the many different practices, service delivery models and education systems for traditional medicine, as well as relevant policy and governance frameworks. Countries have adopted varying strategies to integrate traditional medicine into health systems to date. We consider how to strengthen and build capacity of the traditional medicine workforce so it might better contribute to the UHC agenda. We examine key issues and challenges for traditional medicine, and suggest analytical models for understanding the complexity inherent to integration of traditional medicine and making sense of different components of the traditional medicine workforce. L’utilisation généralisée de la médecine traditionnelle, complémentaire et intégrative (abrégée en « médecine traditionnelle ») à travers le monde suggère que son intégration dans le système de santé officiel est l’une des stratégies permettant d’étendre la couverture sanitaire universelle (CSU). Pour améliorer l’accès aux services de médecine traditionnelle et leur qualité, il faudra veiller à renforcer le personnel travaillant dans ce domaine. Il ne faut pas sous-estimer les défis liés à ces améliorations en raison de la grande diversité des pratiques, modèles de prestation de services et systèmes éducatifs en matière de médecine traditionnelle, ainsi que des cadres politiques et de gouvernance pertinents. À ce jour, des pays ont adopté des stratégies variées pour intégrer la médecine traditionnelle à leurs systèmes de santé. Le présent article examine comment renforcer et élaborer les capacités du personnel œuvrant dans la médecine traditionnelle afin qu’il puisse mieux contribuer aux objectifs de la CSU. Nous y examinons les questions et défis principaux pour la médecine traditionnelle et proposons des modèles analytiques permettant de comprendre la complexité inhérente à l’intégration de la médecine traditionnelle et de donner un sens aux différentes composantes du personnel travaillant dans ce domaine. El uso generalizado de las medicinas tradicionales, complementarias e integrativas (medicina tradicional) en todo el mundo sugiere que la integración de la medicina tradicional en el sistema formal de la salud constituye una estrategia para ampliar la cobertura sanitaria universal (CSU). Mejorar el acceso y la calidad de los servicios de medicina tradicional requerirá prestar atención al fortalecimiento del personal sanitario de este ámbito. No deben subestimarse los desafíos que implica dicho fortalecimiento, dado el gran número de prácticas, modelos de prestación de servicios y sistemas educativos asociados a la medicina tradicional, así como los marcos normativos y de gobernanza pertinentes. Hasta la fecha, los países han adoptado diversas estrategias para integrar la medicina tradicional en sus sistemas de salud. En este artículo, se analiza cómo reforzar y desarrollar la capacidad del personal sanitario dedicado a la medicina tradicional, de modo que pueda contribuir mejor a la agenda de la CSU. Asimismo, se examinan las cuestiones y desafíos fundamentales para la medicina tradicional y se proponen modelos analíticos que facilitan la comprensión de la complejidad inherente a su integración y de los diferentes componentes de su personal sanitario. إن الاستخدام واسع النطاق للطب التقليدي والتكميلي والمتكامل (الطب التقليدي) في جميع أنحاء العالم، يشير إلى أن دمج الطب التقليدي في النظام الصحي الرسمي يُعدّ إحدى الاستراتيجيات لتوسيع نطاق التغطية الصحية الشاملة. لتحسين الحصول على خدمات الطب التقليدي وتحسين جودتها، يتطلب ذلك التركيز على تعزيز القوى العاملة في الطب التقليدي. ولا ينبغي التهوين من التحديات التي تواجه تحقيق هذه التحسينات، نظرًا لاختلاف الممارسات، ونماذج تقديم الخدمات، وأنظمة التعليم في مجال الطب التقليدي، فضلاً عن أطر عمل السياسات والحوكمة ذات الصلة. وقد اعتمدت الدول استراتيجيات متباينة لدمج الطب التقليدي في النظم الصحية حتى الآن. ونحن ندرس كيفية تعزيز وبناء قدرات القوى العاملة في الطب التقليدي، حتى تُسهم بشكل أفضل في تحقيق أجندة عمل التغطية الصحية الشاملة. كما ندرس القضايا والتحديات الرئيسية التي تواجه الطب التقليدي، ونقترح نماذج تحليلية لفهم التعقيد الكامن في دمج الطب التقليدي وفهم مختلف مكونات القوى العاملة للطب التقليدي. 传统、补充和整合医学（传统医学）在世界各地的广泛使用表明，将传统医学整合至正规卫生系统是有助于扩大全民健康覆盖 (UHC) 范围的一项策略。为了提升传统医学服务的可及性和质量，需要着重发展传统医学卫生人员队伍。由于各国在传统医学相关实践、服务提供模式、教育系统以及相关政策和治理框架方面存在巨大差异，因此，在提升此类服务的可及性和质量过程中面临的这些挑战不容轻视。迄今为止，为了将传统医学整合至卫生系统，各国已推行了各种策略。我们考虑了如何加强和推行传统医学卫生人员队伍的能力建设，以便其能更好地推进 UHC 议程。我们研究了在推行传统医学方面会遇到的关键问题和挑战，并提出了分析模型，以期了解传统医学整合过程固有的复杂性以及传统医学卫生人员队伍的不同组成部分。. Широкое использование традиционной, комплементарной и интегративной медицины (традиционной медицины) во всем мире позволяет предположить, что интеграция традиционной медицины в официальные системы здравоохранения является одной из стратегий расширения всеобщего охвата услугами здравоохранения (universal health coverage, UHC). Улучшение доступа к услугам традиционной медицины и повышение их качества потребует усилий для укрепления кадровых ресурсов традиционной медицины. Не следует недооценивать сложности на этом пути, так как в традиционной медицине существует множество различных практик, моделей оказания услуг и систем обучения традиционной медицине; различаются между собой также политики и рамочные стратегии на уровне правительств. В настоящее время в странах по-разному подходят к интеграции традиционной медицины в системы здравоохранения. Авторы рассматривают вопрос укрепления и развития возможностей работников традиционной медицины с тем, чтобы они лучше отвечали насущным задачам UHC. В статье рассмотрены основные проблемы и сложные аспекты, связанные с традиционной медициной, а также предлагаются аналитические модели для осмысления сложностей интеграции традиционной медицины и понимания различных компонентов кадровых ресурсов, присущих данной сфере.
BACKGROUND: Chronic diseases account for 74% of global deaths. In the UK, multimorbidity prevalence is projected to nearly double by 2035. Addressing this burden requires a holistic, multidisciplinary approach that considers genetic, lifestyle, environmental, and psychosocial factors. The increasing focus on holistic care has revived interest in traditional and complementary healthcare practices, with a 2013 survey indicating that 23.6% of the UK’s ethnic population utilizes these modalities. Among these practices, Ayurveda has gained significant global traction. Despite the growing popularity of Ayurveda, discussions between patients and healthcare professionals (HCPs) remain limited. Consequently, patients often explore Ayurveda centres independently, risking unreliable sources that could have serious consequences on their health. Opening conversations about Ayurveda is crucial to ensure patients are well-informed. These conversations largely depend on the awareness, attitudes, and having the confidence and the ability to signpost patients to reputable Ayurvedic centres. METHODS: The study utilized a cross-sectional survey to assess UK HCPs’ awareness, attitudes, and training needs on Ayurveda. After a pilot test, an anonymous Google Form was distributed, yielding 147 responses. Cronbach’s alpha for the questionnaire was 0.9261, indicating high internal consistency. Descriptive statistics, Chi-Square Test, and Fisher’s Exact Test were used for data analysis. RESULTS: Of 147 surveyed HCPs, 10.2% were very familiar with Ayurveda, 46.3% somewhat familiar, and 43.5% had little to no familiarity. Herbal medications (59.6%) and dietary interventions (41.1%) were most recognized. Only 10.9% fully understood Ayurveda’s known safety and effectiveness. Most (80.3%) felt unprepared to advise patients on Ayurveda, and majority (83%) had no formal training. Regarding attitudes, 46.2% supported including Ayurveda as a treatment option, and 82.3% thought it should be regulated by the Medicines and Health Products Regulatory Agency (MHRA) or the NHS. The majority (70.7%) favoured collaboration with Ayurvedic practitioners. Attitudes about Ayurveda’s role in chronic disease varied, with 47.7% believing it could help those not benefited by conventional medicine. A strong majority (83.7%) supported patient education on its benefits and risks, and most (86.4%) willing to learn more. In terms of patient engagement, nearly half (47.6%) refrained from offering definitive advice on Ayurveda, and only a few (8.8%) referred patients to Ayurvedic practitioners. However, most (84.4%) supported interprofessional cooperation. Key challenges to integration included lack of scientific evidence (55.1%) and limited understanding (44.2%), with many advocating for research (51.7%) and education (45.6%). Ethnicity significantly influenced responses (p<0.001), with Asians showing familiarity but limited understanding, Black respondents displaying more knowledge and support for integration, and White respondents expressing scepticism and a need for regulation. CONCLUSION: The survey highlights significant gaps in awareness and understanding of Ayurveda among UK healthcare professionals, alongside varying attitudes toward its integration in chronic disease management. Most HCPs expressed support for collaboration with Ayurvedic practitioners and for educating patients about its benefits and risks. These findings underscore the need for enhanced education and structured training programs for HCPs to enable safe and informed discussions about Ayurveda in clinical practice. In response to the identified gaps, an educational video was subsequently developed by the University of Birmingham for HCPs to address knowledge gaps and support informed patient decisions on Ayurveda.
Our aim is to explore the combined effects and the potential mechanism between Huang-qin decoction (HQD) and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer (NSCLC) cells in vitro and in vivo. Ultra-high performance liquid chromatography (UPLC) was done to detect the consistency of ingredients in different batches of HQD. Cell counting kit-8 (CCK-8) assay, 5-Ethynyl-2'-deoxyuridine (EdU) assay, colony formation assay and Annexin V-FITC/PI assay were performed to detect the anti-cancer effects of HQD and EGFR-TKIs (1st generation EGFR-TKI gefitinib or 3rd generation EGFR-TKI Osimertinib) in different NSCLC cell lines. ATP assay was applied to detect the effect of HQD and EGFR-TKIs in NSCLC cell lines and organoids in three-dimensional (3D) culture. The mRNA expression levels of lung cancer stem cell markers makers and redox related genes, such as sex determining region Y-box 2 (SOX2), aldehyde dehydrogenase 1 family, member A1 (ALDH1A1), glutathione peroxidase 4 (GPX4), dual oxidase 1 (DUOX1) and dual oxidase 2 (DUOX2), were detected by using quantitative real-time PCR assay. Western blot methods were done to detect the effects of EGFR-TKIs and HQD on the protein expression levels of SOX2, ALDH1A1, GPX4, signal transducer and activator of transcription 3 (stat3) and p-stat3. Besides, the alteration of intracellular total reactive oxygen species (ROS) levels of NSCLC cells in 2D culture and 3D culture after the treatments were detected using DCFH-DA staining assay and fluorimetric intracellular total ROS activity assay, respectively. Femtosecond laser labeling free imaging (FLI) method was used to detect the redox ratio of NSCLC cells in 3D culture. In vivo experiments included subcutaneous mice xenografts of PC-9-PIK3CA-M cells to validate the anti-cancer effect, mechanism and safety of gefitinib and HQD in vivo. The consistency of ingredients in different batches of HQD was confirmed. HQD enhanced the anti-proliferation and pro-apoptosis effect of gefitinib or Osimertinib in NSCLC cell lines and organoids both in 2D culture and 3D culture in vitro. The combination of HQD and EGFR-TKIs could regulate stat3/GPX4 signal pathway to induce redox ratio, thus increasing ROS levels to inhibit CSC markers in vitro. Moreover, the drug safety, anti-cancer effect and potential mechanism of the therapy of HQD and EGFR-TKIs were confirmed in vivo. HQD enhances the anti-cancer effect of EGFR-TKIs in NSCLC through ROS-mediated CSC makers inhibition by suppressing stat3/GPX4 axis to induce redox ratio, providing a novel strategy for the treatment of NSCLC patients.
BACKGROUND: The International Questionnaire to Measure the Use of Complementary and Alternative Medicine (I-CAM-Q) is a standardized tool for assessing CAM use. While it has been adapted into several languages, this study presents the first Hungarian translation and cultural adaptation. Given the growing interest in CAM in Hungary, a validated Hungarian version is essential for accurate data collection and informed healthcare policy. METHODS: The I-CAM-Q was translated into Hungarian using a rigorous forward–backward translation protocol involving expert translators, proofreaders, and a reconciliation panel. The final version was pilot-tested among healthy volunteer healthcare workers from ophthalmology departments. The questionnaires were used to assess clarity, cultural relevance, and reliability in this cross-sectional study. Individuals with diagnosed eye diseases were excluded. RESULTS: Among ophthalmologically healthy volunteers, 77.8% consulted physicians in the past 12 months, while 8.9% visited chiropractors and spiritual healers, and 2.2% consulted acupuncturists. In the past 3 months, physicians remained the most consulted (73.7%), followed by chiropractors (53.3%). CAM therapies were mainly used for general well-being and acute conditions, with high satisfaction 75–100% of users rated chiropractic, acupuncture, and spiritual healing as “very useful.” Phytomedicines were used primarily for acute illness (41.7%) and general well-being (27.1%), with 68.1% of users rating them as very useful. Dietary supplements were widely consumed, especially Vitamin D (62.9%) and Vitamin C (57.1%), mainly for prevention (46.2%) and general health (38.5%). Meditation and relaxation techniques were also commonly practiced, with 92.3% and 69.2% of users, respectively, rating them as very useful. CONCLUSIONS: The Hungarian version of the I-CAM-Q was successfully translated, culturally adapted, and validated. It provides a reliable tool for assessing CAM use in Hungary and supports further research into CAM practices and their integration into healthcare.
Postoperative insomnia is one of the common complaints caused by spinal metastatic cancer surgery. It affects patients' functional recovery, greatly reduces their quality of life, and adversely impacts disease prognosis. Compared with traditional pharmacological treatments, acupuncture is an alternative therapy for postoperative insomnia. However, standardized, high-quality randomized controlled trials on electroacupuncture for postoperative insomnia in patients with spinal metastasis (SM) are scarce, and there is a lack of clear inclusion criteria for this specific population. Postoperative insomnia in patients with SM has distinct clinical characteristics compared with general cancer-related insomnia, necessitating targeted investigation. This study aims to evaluate the efficacy and safety of electroacupuncture in the treatment of postoperative insomnia in patients with SM, and to provide high-level clinical evidence for the inclusion of electroacupuncture in the clinical management plan of postoperative insomnia in patients with SM. This is a study protocol for a randomized controlled trial. We will randomly assign 196 patients with insomnia after spinal metastatic cancer surgery to the acupuncture group (n=98) or the control group (sham acupuncture group; n=98). All participants will be treated on the first day after surgery and receive 12 sessions in total (30 min per session, 3 sessions per wk for 4 weeks). The primary outcome is the change in Pittsburgh Sleep Quality Index score from baseline to post treatment (wk 4). The secondary outcomes include actigraphy records (sleep efficiency, number of sleep awakenings, total sleep time, sleep latency, and wake after sleep onset), Insomnia Severity Index, Spine Oncology Study Group Outcomes Questionnaire 2.0, and Patient Health Questionnaire-9. All results will adhere to the intention-to-treat principle and will be evaluated at baseline, posttreatment (wk 4), and follow-up (wk 12). This study was funded in June 2023 (supported by the Project of Shanghai Municipal Health Commission, National Natural Science Foundation of China, etc). Recruitment will start in mid-2026 and end in December 2027. Data collection will be completed in October 2027, and data analysis is expected to be finished in December 2027. The results of this study are anticipated to be published in the first half of 2028. This study is designed to rigorously assess the therapeutic value of electroacupuncture for postoperative insomnia in patients with SM. If proven effective, electroacupuncture is expected to become a safe and feasible alternative or complementary therapy for this population, reducing reliance on hypnotic drugs and improving patients' quality of life and prognosis. The results will fill the gap in current clinical evidence for electroacupuncture in the treatment of spinal metastatic postoperative insomnia and provide a basis for the optimization of clinical treatment strategies.
Increasing life expectancy has increased focus on the health-related consequences of aging, such as sarcopenia and frailty. Given the prevalence of these conditions among older individuals and the frequent resulting long-term care needs, early detection and intervention are crucial. This study aimed to validate a novel smartphone-based system measuring acceleration during the sit-to-stand movement to detect sarcopenia and frailty. Participants were 587 individuals from the Otassha study cohort who underwent health assessments in 2023, of whom 569 (96.9%) completed 2 supervised sit-to-stand trials while holding a smartphone on the lower abdomen. Sarcopenia and frailty were diagnosed using the Asian Working Group for Sarcopenia 2019 criteria and the revised Japanese Cardiovascular Health Study criteria, respectively. Peak force, rising time (T1), and stabilization time (T2) were extracted from acceleration signals, and reproducibility was examined using the intraclass correlation coefficient (ICC(2,1)). Predictive models were developed using elastic net penalized logistic regression, and model performance was evaluated using 500 bootstrap resamples. Benchmark models using age and sex, walking speed, and grip strength were also constructed for comparison. Sarcopenia and frailty were identified in 16.7% (95/569) and 9% (51/569) of the participants, respectively. Peak force demonstrated excellent reliability (ICC=0.863), whereas T1 and T2 showed lower reproducibility (ICC<0.30). For sarcopenia, the smartphone model achieved a bootstrap area under the receiver operating characteristic curve (AUC) of 0.800 and an optimism-corrected AUC of 0.781 (95% CI 0.733-0.826), outperforming walking speed (0.663) and age and sex (0.656) and ranking second only to grip strength (0.845). For frailty, the smartphone model showed moderate discrimination, with an optimism-corrected AUC of 0.659 (95% CI 0.587-0.736), exceeding age and sex (0.604), whereas walking speed remained the strongest predictor (0.751). Smartphone-derived sit-to-stand acceleration provides a practical and scalable approach for screening for sarcopenia and frailty in community-dwelling older adults. While traditional indicators such as grip strength and walking speed remain the most accurate predictors, smartphone-based measurements offer meaningful complementary information and may support large-scale functional screening and early detection initiatives in superaged societies.
Families of children with cancer and nonmalignant blood disorders frequently explore complementary medicine (CM). Despite growing evidence supporting CM for pediatric populations, physician communication about its use remains limited. This study evaluates caregiver awareness, interest, and use of CM among pediatric hematology/oncology patients. A cross-sectional survey was conducted among caregivers at the University of North Carolina Pediatric Hematology/Oncology Clinic (May-September 2024). Eligible participants spoke English or Spanish and had attended at least one clinic visit. The survey assessed awareness and use of CM, including nutrition, supplements, mind-body practices (e.g., prayer, acupuncture, and yoga), and whole medical systems (e.g., traditional Chinese and Ayurvedic medicines)-as well as costs, motivations, and barriers. A total of 150 caregivers completed the survey. Only 30% of respondents were familiar with CM terminology, yet 58% reported using at least one CM form. Dietary modifications were most common (47%), followed by mind-body practices (20%). Caregivers of cancer patients prioritized CM to reduce treatment side effects, whereas caregivers for those of patients with nonmalignant hematology conditions prioritized long-term quality-of-life. Barriers included lack of awareness (61%) and cost (15%). Only 17% had discussed CM or PIM (pediatric integrative medicine) with clinicians, and in most cases (60%), caregivers initiated the conversation. Findings highlight significant gaps in awareness, access, and clinician-family communication regarding pediatric CM. Despite limitations such as single-site design and modest sample size, results underscore the need for caregiver education and accessible services to better support pediatric patients and families.
Frailty and sarcopenia represent substantial global health challenges, frequently diminishing patients' quality of life through impaired muscle function and physical performance. Digital health interventions (DHIs) have shown promise in mitigating these conditions among older adults. However, outcomes of such interventions in this demographic are inconsistent, and a thorough synthesis of existing evidence is lacking. This study aimed to evaluate the effectiveness of DHIs in older adults with frailty and sarcopenia. A comprehensive search of PubMed, Web of Science, MEDLINE, Embase, and Cochrane Library was conducted from their inception until January 2026 to identify randomized controlled trials. Meta-analyses were performed using R software (R Foundation for Statistical Computing). Study quality was evaluated using the revised Cochrane Risk of Bias Tool 2.0 (Cochrane Collaboration), and evidence certainty was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). From 3506 records, 16 studies were included. DHIs significantly improved total skeletal muscle mass (weighted mean difference [WMD] 1.01, 95% CI 0.08-1.94, 95% prediction interval [PI] -0.95 to 2.96), gait speed (WMD 0.09, 95% CI 0.03-0.15, 95% PI -0.1 to 0.26), Timed Up and Go Test (TUGT: WMD -0.52, 95% CI -1.02 to -0.03, 95% PI -1.93 to 0.85), 30-second Chair Stand Test (30CST: WMD 2.19, 95% CI 0.89-3.48, 95% PI -1.59 to 5.66), balance (standardized mean difference [SMD] 0.61, 95% CI 0-1.21, 95% PI -0.94 to 2.13), and quality of life (SMD 0.16, 95% CI 0.05-0.27, 95% PI 0.04-0.28). No significant improvements were observed in Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-minute walk test (6MWT), 2-minute walk test (2MWT), Short Physical Performance Battery (SPPB), or BMI. Although the pooled effect was favorable, the wide 95% PI suggests substantial between-study heterogeneity. Subgroup analysis stratified by intervention duration revealed significant intersubgroup differences in ASMI (χ²₁=9.93; P=.0016), indicating interventions lasting ≥12 weeks were more effective for improving ASMI (WMD 0.28, 95% CI 0.06-0.50, 95% PI -0.30 to 0.83). Subgroup analysis stratified by intervention type showed significant intersubgroup differences in balance (χ²₃=9.89; P=.0195), with exergame-based interventions showing significant effects (SMD 0.83, 95% CI 0.26-1.40). This systematic review is the first to quantify the disease-specific efficacy of DHIs in improving muscle function, physical performance, and quality of life among older adults with frailty and sarcopenia, demonstrating their unique value as a scalable complementary approach. By overcoming geographical and resource constraints, DHIs support underserved populations. However, low evidence quality and heterogeneity warrant cautious interpretation. The 95% PIs indicate that actual effects may vary with population characteristics and implementation contexts. Nonetheless, DHIs represent a promising and cost-effective strategy for service expansion. Future high-quality studies are needed to better understand their effectiveness and implementation across settings.
Livsooth Authentic Herbal Formula (LAH) is a novel Chinese herbal medicine that has been previously shown to prevent non-alcoholic fatty liver disease (NAFLD). However, its efficacy in treating obesity and its underlying mechanisms remain unclear. This study uniquely investigates the therapeutic effects of LAH on high-fat diet (HFD)-induced obese mice, focusing on its multi-targeted regulation of metabolic pathways. This research highlights the potential of a multi-component herbal formula in simultaneously activating the AMPK pathway, regulating lipid metabolism, and enhancing antioxidant defenses. By integrating network pharmacology predictions with proteomics analysis, in vivo, and in vitro experiments, this study provides a comprehensive understanding of LAH's mode of action. Mice were fed a high-fat diet (HFD) for 8 weeks, followed by oral treatment with LAH at doses of 615 mg/kg and 2460 mg/kg for 10 weeks. Each treatment group consisted of 6 mice. Body weight, blood biochemistry, and antioxidant enzyme activities were measured. Network pharmacology and proteomics analyses were conducted to identify mechanisms, and in vitro studies validated molecular pathways. This study utilized network pharmacology to investigate the therapeutic effects and mechanisms of LAH on obesity. Through relevant databases, 19 major chemical components and 605 potential targets were identified. KEGG pathway analysis identified the AMPK signaling pathway as a key target of LAH. Animal experiments showed that LAH reduced body weight by 16.55 % compared to HFD-induced mice. In addition to weight reduction, LAH significantly improved serum metabolic parameters. Glucose, triglyceride, and cholesterol levels were significantly reduced, and liver function improved, with ALT decreasing from 142.00 ± 32.63 U/L (HFD) to 63.57 ± 33.16 U/L (H-LAH), and AST from 147.20 ± 12.92 U/L (HFD) to 81.71 ± 31.31 U/L (H-LAH). It also enhanced liver antioxidant enzyme activity and reversed oxidative stress. Proteomics analysis revealed that LAH treatment downregulated the expression of FASN, HMGCR, and SREBP1 while upregulating PRKAA1, PRKAA2, ACACA, SOD1, and GSTP1, which are linked to the AMPK pathway and antioxidant mechanisms. In vitro experiments confirmed that LAH ameliorates hepatic steatosis by activating the AMPK pathway, as evidenced by its regulation of p-ACC, p-AMPK, CPT1A, FAS, and SREBP1 protein expression, identifying it as a critical regulator of obesity and NAFLD. LAH reduces the expression of FAS and SREBP1 proteins via the AMPK pathway, while enhancing the activity of antioxidant enzymes. These effects promote weight loss and improve hepatic lipid metabolism, supporting its potential as a therapeutic agent for obesity and related metabolic disorders. This provides a theoretical foundation for using LAH in weight management.
Reassurance-seeking behaviour as a symptom of health anxiety (HA) is proposed as one important reason for healthcare use in conventional healthcare. However, we know little about the association between HA and traditional and complementary medicine (T&CM), especially for provider visits. This paper aims to address this knowledge gap by examining the association between HA and T&CM provider visits in a large, adult general population. This study used cross-sectional data from the seventh survey (2015-2016) of the Tromsø Study, where 19 639 participants responded to questions about visits to T&CMs providers the past 12 months, as well as a questionnaire on HA. T&CM visits were registered as (1) a complementary medicine (CM) provider, (2) an acupuncturist, (3) a traditional healer (TM), or (4) any of the above. Whiteley Index-6-R was used to measure HA as a continuous construct ranging from 0 to 24. Logistic regression was used to analyse the associations. Mental and somatic illness, demographic and socioeconomic variables were included as confounders. HA was significantly and positively associated with visits to all T&CM practitioners, where a 1-point increase in the HA score was associated with 5-7% higher odds for visits across all types of T&CM practitioner categories. The results were not significantly altered by adjusting for mental and somatic illness, demographic nor socioeconomic variables for the population as a whole, but interaction analyses showed that HA was not significantly associated with visits to TM providers in participants reporting multimorbidity. Moreover, HA was more strongly associated with CM provider use in men, than women. In our large, adult general population, we found consistent and significant associations between HA and visits to a T&CM provider. This can indicate that HA warrants recognition in T&CM visits. Not applicable.
Breast cancer (BC) is a major cause of cancer-related mortality worldwide. While mainstream anticancer therapies have improved clinical outcomes, they are often associated with significant toxicity and drug resistance. Traditional Chinese medicine (TCM) has received increasing recognition as a valuable complementary approach in oncology. This review summarizes the current evidence supporting the integrative use of TCM in BC management. Clinical studies indicate that TCM formulations can alleviate the adverse effects induced by chemotherapy and targeted therapy to thereby enhance patients' quality of life and treatment adherence. As an adjuvant, TCM also shows the potential to improve both the efficacy of conventional treatments and survival outcomes. Preclinical investigations reveal that bioactive herbal compounds exert multi-target antitumor effects by modulating key mechanisms such as programmed cell death, proliferation, metastasis, cell-cycle progression, drug resistance, aerobic glycolysis, and antitumor immunity. Furthermore, advanced drug delivery systems are being developed to overcome the inherent limitations of herbal compounds. However, challenges which warrant further investigation, including heterogeneous study designs, the standardization of formulations, and potential herb-drug interactions, remain under-explored. Overall, TCM represents a promising complementary strategy for BC. Future efforts should prioritize well-designed clinical trials, mechanistic elucidation, and the development of integrated precision medicine models to optimize patient care.
Primary health care (PHC) systems are increasingly challenged by the rising burden of chronic diseases and the growing demand for personalized care. Persian Medicine (PM), with its constitution-based approach and rich historical foundation, holds significant potential as a complementary strategy in population health management within the PHC framework. This study aimed to explore the barriers and facilitators to integrating PM into the PHC system from the perspectives of Community Health Workers (CHWs) and Community Health Supervisors (CHSs). A qualitative descriptive design with thematic analysis was employed. Data were collected through semi-structured interviews with 18 CHWs and CHSs in Primary Healthcare Centers (PHCs) in Tabriz, Iran. Purposive sampling with maximum variation was used to ensure diversity of perspectives. Data were analyzed using the Braun and Clarke framework with MAXQDA version 24. To ensure trustworthiness, member checking and peer debriefing were conducted by independent researchers. Five main themes emerged: (1) challenges in designing and integrating PM assessment tools into PHC; (2) structural and policy-level barriers; (3) challenges in health education and information acceptance; (4) human resource constraints and motivation; and (5) facilitating factors and participant-driven strategies. The first four themes represent barriers, while the fifth highlights strategies for successful PM integration into PHC. The successful integration of PM into PHC requires a comprehensive strategy Empowering healthcare personnel, developing evidence-based protocols, improving health literacy, and fostering collaboration between PM and conventional medicine are essential steps toward achieving this goal.
BackgroundTraditional, complementary, and integrative medicine (TCIM) is an evolving field in oncology focused on managing cancer symptoms. Hydrogen water (HW) has gained attention for its antioxidant and anti-inflammatory properties, yet its clinical effectiveness needs further exploration. This randomized controlled trial aimed to assess the impact of gargling with HW on oral mucositis severity, pain levels, oral frailty, and quality of life in head and neck cancer patients undergoing radiotherapy or concurrent chemo-radiotherapy.MethodsIn this single-center, single-blind, parallel-group randomized controlled trial, patients were randomly assigned to receive either HW or distilled water (DW) for gargling. Oral mucositis (OM) severity, pain, oral frailty, and quality of life (QoL) were assessed using the World Health Organization Oral Mucositis Grading Criteria (WHO-OMGC), the Brief Pain Inventory-Taiwan (BPI-T), the Oral Frailty Checklist (OFC), and the EORTC QLQ-H&N35 questionnaire. Assessments were conducted at baseline (T0) and on Days 1 (T1), 3 (T2), 7 (T3), and 14 (T4) post-treatment.ResultsThe HW group showed significant OM improvement at Day 7 (p = 0.04) and Day 14 (p = 0.002). Pain decreased significantly in the HW group at Day 14 (p = 0.02). QoL improved in the HW group (p = 0.03), while OFC scores showed no significant difference between groups (p = 0.74).ConclusionHW gargling significantly alleviated OM severity and pain and improved QoL in head and neck cancer (HNC) patients undergoing radiotherapy or CCRT. HW gargling may serve as a simple, well-tolerated, and effective complementary and integrative therapy during cancer treatment.
Perimenopausal symptoms affect most women and often substantially impair their quality of life, whereas conventional estrogen therapy alone does not fully address clinical needs. Baoqing granules (BQG), derived from Zuo Gui Wan in Jingyue's Complete Works, were modified to target kidney Yin deficiency and have shown promising clinical efficacy, although robust randomized evidence remains limited. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300073338; http://www.chictr.org.cn). In this randomized, double-blind, placebo-controlled clinical trial, eligible perimenopausal women received either Femoston plus placebo or Femoston plus BQG for four weeks, followed by a four-week follow-up. The primary outcomes were the Modified Kupperman Menopausal Index (Modified KMI) and traditional Chinese medicine (TCM) syndrome scores. Secondary outcomes included the Menopause-Specific Quality of Life Questionnaire (MENQOL), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and serum levels of sex hormones and lipids. Safety was evaluated through hepatic and renal function tests and adverse-event monitoring. Both groups showed significant improvements from baseline; however, participants in the BQG group experienced greater short-term improvements that persisted at week 8 in Modified KMI, TCM syndrome scores, MENQOL, and PSQI, while differences in SAS and SDS became significant only at follow-up. Hormone and lipid profiles showed no overall between-group differences, although exploratory subgroup analyses suggested higher estradiol and lower follicle-stimulating hormone levels in postmenopausal women receiving BQG. Liver and kidney functions remained within normal ranges, and only one mild adverse event was reported. In this 8-week study, BQG as an adjunct to Femoston was associated with additional short-term improvements in multidimensional perimenopausal symptoms, with acceptable tolerability. These findings support the potential role of BQG as a complementary therapy; however, longer-term studies are needed to confirm the durability of benefit and long-term safety. http://www.chictr.org.cn, identifier ChiCTR2300073338.
While oral Chinese herbal medicine (OCHM) is frequently used for cancer pain (CP), its combined effects with opioids remain unclear. This study aims to evaluate the efficacy and safety of OCHM combined with opioids in patients with moderate to severe CP. We systematically searched five Chinese and English databases up to December 30th, 2024, for randomized controlled trials comparing OCHM plus opioids versus opioids alone. Primary outcomes were pain relief and pain intensity. Secondary outcomes included onset and duration of pain relief, Karnofsky Performance Status (KPS) score, and adverse events. Meta-analysis of 18 trials revealed that OCHM plus opioids had a lower pain intensity (standardized mean difference [SMD] = -1.70; 95 % CI = -2.31 to -1.08; P < 0.001), higher incidence of pain relief (risk ratio [RR] = 1.25; 95 % CI = 1.20 to 1.31; P < 0.001) and KPS score (mean difference [MD] = 11.32; 95 % CI = 7.17 to 15.47; P < 0.001), shorter onset time of pain relief (MD = -13.27 minutes; 95 % CI = -14.42 to -12.11; P < 0.001), longer duration of pain relief (MD = 2.67 hours; 95 % CI = 2.13 to 3.21; P < 0.001), lower incidence of nausea/vomiting (RR = 0.51; 95 % CI = 0.41 to 0.62; P < 0.001), and constipation (RR = 0.60; 95 % CI = 0.51 to 0.69; P < 0.001). OCHM plus opioids improved pain relief, enhanced the quality of life, reduced opioid-related adverse events in patients with moderate to severe CP compared to opioids alone.
Bulb of Fritillaria ( Bèi Mǔ) has been wildly used in Chinese medicine for serval centuries since its significant therapeutic effects on respiratory diseases, such as cough, expectoration, pneumonia, and bronchial inflammation. Verticinone is the main active ingredient in bulbs of Fritillaria. The novel verticinone derivatives are synthesized by verticinone and different bile acids and showed promising anti-lung cancer properties. This study aims to compare the ability of three novel verticinone derivatives (HDCA-Ver, CDCA-Ver and DCA-Ver) inhibiting A549 and MDA-MB-231 cells proliferation in vitro, and to investigate the inhibiting mechanism of CDCA-Ver on lung cancer. CCK-8 observed the effect of CDCA-Ver, DCA-Ver and HDCA-Ver on A549 and MDA-MB-231 cells. Annexin-FITC/PI double, Hoechst 33258, and PI staining were used to evaluate the ability of CDCA-Ver inducing A549 cells apoptosis. Network pharmacology and transcriptomics were also performed to further analyze the molecular mechanisms of CDCA-Ver therapy for lung cancer. We found that CDCA-Ver, DCA-Ver and HDCA-Ver could significantly inhibit A549 and MDA-MB-231 cells proliferation. CDCA-Ver could significantly induce A549 cells apoptosis and G0/G1 cell cycle arrest. Network pharmacology demonstrates that the potential targets of CDCA-Ver mainly include "EGFR tyrosine kinase inhibitor resistance". According to transcriptome analysis, CDCA-Ver mainly activated "Metabolic pathways" and "Cell cycle" targets. This study could provide scientific basis for the application of CDCA-Ver.
Angelica decursiva (Umbelliferae) is a medicinal plant widely used to treat colds, coughs and fevers in Korea, Japan, and mainland China. The anti-inflammatory activity of nodakenetin, a furano-coumarin compound from A. decursiva, has been reported, although, the antiosteoporotic activity remains unknown. This study sought to investigate the antiosteoporotic activity and precise mechanism of action of nodakenetin in vitro cell culture and in vivo bone remodeling models. The transcriptional activity of nodakenetin on the Wnt signaling pathway was assessed using the TOPflash/FOPflash assay. The effect of nodakenetin on the osteoblast differentiation was measured using Alizarin red staining and alkaline phosphatase (ALP) activity. Western blotting and real-time RT-PCR were used to assess the effect of nodakenetin on the expression of markers related to Wnt/β-catenin pathway and osteoblast differentiation. The in vivo antiosteoporotic activity of nodakenetin was assessed using an ovariectomized (OVX)-induced bone loss mouse model. Nodakenetin activated the Wnt/β-catenin pathway through regulation of DKK1, β-catenin and other target proteins of the Wnt/β-catenin pathway in HEK293 and MC3T3-E1 cells. Nodakenetin induced the differentiation of MC3T3-E1 cells as shown by enhanced Alizarin red staining and ALP activity. Induction of osteoblast differentiation was related to upregulated expression of bone formation biomarkers such as bone morphogenic proteins and Runx2. Oral administration of nodakenetin in the OVX mouse model effectively protected the deterioration of bone microstructure in OVX mice. Nodakenetin exhibits antiosteoporotic activity in vitro and in vivo through the activation of the Wnt/β-catenin pathway and subsequent induction of osteoblast differentiation.