Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine.

Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains-which are similar to moxibustion usages-have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended. Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; 21(4):354-360.

Effectiveness of acupuncture for fatigue in patients with relapsing-remitting multiple sclerosis: a randomized controlled trial.

BACKGROUND: Fatigue is experienced by more than 65% of individuals with multiple sclerosis (MS). Some studies have supported the effectiveness of acupuncture in improving the symptoms of MS. OBJECTIVE: The present research was intended to investigate the effectiveness of acupuncture plus amantadine compared with amantadine alone on fatigue in patients with relapsing-remitting MS (RRMS) in the remission stage of the disease. METHODS: In this randomized controlled trial, 60 participants with RRMS suffering from fatigue were recruited and randomized equally to acupuncture (n = 30) and control (n = 30) groups. The acupuncture group received treatment 2 to 3 times per week for 10 sessions over 4 weeks. Both the acupuncture and control groups received amantadine 100 mg daily and routine treatment with immuno-modulators. The primary outcome was the fatigue severity scale (FSS) score, which was evaluated at baseline, and after 2 and 4 weeks. The secondary outcome was the Multiple Sclerosis Quality of Life 54 (MSQOL-54) questionnaire score, measured at baseline and the end of the 4-week treatment period. RESULTS: The severity of fatigue was reduced in both groups. However, after 4 weeks of treatment, the reduction of fatigue in the acupuncture group was more significant than in the control group (P < 0.01, mean difference (MD) = -1.14, 95% confidence interval (CI): -1.83 to -0.45). Quality of life, including mental and physical status, was significantly improved in the acupuncture group compared with the control group (P < 0.05, MD = 9.09, 95% CI: 0.46 to 17.73). No adverse events occurred in any of the participants. CONCLUSIONS: Acupuncture combined with amantadine and routine care compared with amantadine and routine care alone appears to be an effective short-term treatment for reducing fatigue and enhancing quality of life, including physical function and mental status, in patients with RRMS.

Acupuncture or cupping plus standard care versus standard care in moderate to severe COVID-19 patients: An assessor-blinded, randomized, controlled trial.

Background: Non-pharmacological strategies that have been proposed by complementary medical systems, can be effective in management of COVID-19. Methods: This study was designed as a three-arm, assessor-blinded, randomized controlled trial. A total of 139 hospitalized COVID-19 patients were randomly assigned into three groups: (1) acupuncture (ACUG), (2) cupping (CUPG), and (3) control (CTRG). All participants received conventional treatment. The primary study endpoint included changes in respiratory signs including oxygen saturation (SpO2) and respiratory rate (RR). The secondary endpoints were COVID-19-related hospitalization duration and serious adverse events such as intensive care unit (ICU) admission, intubation or death, all up to day 30. Also, improvements in cough, dyspnea, chest tightness, oxygen demand, anorexia, headache, weakness, sore throat, and myalgia were evaluated. Results: Forty-two patients in ACUG, 44 patients in CUPG, and 42 patients in CTRG completed the trial. After 3 days, SpO2 and RR improved significantly in CUPG and ACUG compared with CTRG (effect size: 8.49 (6.4 to 10.57) and 8.51 (6.67 to 10.34), respectively: p<0.001). Compared with CTRG, patients in CUPG and ACUG recovered faster (mean difference: 6.58 (4.8 to 8.35) and 9.16 (7.16 to 11.15), respectively) and except for two patients in ACUG who were admitted to ICU, none of patients in ACUG or CUPG needed ICU or intubation (p<0.001 in comparison to CTRG). Amelioration of clinical COVID-19 related symptoms reached a high level of statistical significance in CUPG and ACUG in comparison with CTRG (p<0.01). Conclusion: Cupping and acupuncture are promising safe and effective therapies in management of COVID-19. Trial registration: This study was registered at Iranian Registry of Clinical Trials: IRCT20201127049504N1 (https://en.irct.ir/trial/52621).

Warm Cupping of the Posterior Thorax in Combination with Standard Conventional Therapy for ARDS in COVID-19 Patients in ICU: a Case Series.

Acute respiratory distress syndrome (ARDS) is commonly found in critically ill patients with coronavirus disease 2019 (COVID-19). As a non-pharmacological treatment of complementary and alternative medicine (CAM), cupping has been clinically used for respiratory symptoms. We sequentially identified a series of patients with COVID-19 with ARDS who were admitted to the intensive care unit (ICU). Warm cupping of the posterior thorax was performed for seven days. We collected longitudinal severity scores on cough, breathlessness, chest tightness, type of oxygen therapy, and oxygen saturation (SpO2). We hereby report the changes in the severity scores in a series of eight patients who received 21 sessions of cupping in addition to conventional treatments. All patients reported improvement in symptom scores that was matched by an increase in SpO2 by as much as 3.16%. All patients were discharged and did not require the use of a mechanical ventilator. The results suggest that combining cupping with conventional treatment may provide a good prognosis for patients with COVID-19 with ARDS.

Comparison of therapeutic effects of statins and aloe vera mouthwash on chemotherapy induced oral mucositis.

BACKGROUND: Chemotherapy induced oral mucositis is a common problem among patients with cancer. Different therapeutic agents have been evaluated to prevent or treat the disease. Here we aimed to compare therapeutic effects of atorvastatin and aloe vera mouthwash on chemotherapy induced oral mucositis. METHODS: 120 patients with large intestine and gastric cancer who were treated with 5-fluorouracil (FOLFOX4) for the first time were entered and randomized into 3 groups. Group 1 received tablets of atorvastatin 10 mg daily until 2 weeks after chemotherapy sessions plus placebo mouthwash. Group 2 received aloe vera mouthwash plus placebo tablets and group 3 received placebo mouthwash and placebo tablets until 2 weeks after chemotherapy sessions. Severity of mucositis was assessed using world health organization (WHO) indexes. Based on this method, mucositis is divided into 4 grades. This study was approved by Iranian Registry of Clinical Trials (IRCT) with the code of: IRCT20201203049585N1 (https://fa.irct.ir/trial/54037). RESULTS: Analysis of the incidence of mucositis among patients showed that in placebo group, 50% of patients experienced grade 2 to 4 mucositis. In group 1, 9 patients (22.5%) had grade 2 mucositis and 6 patients (15%) had grade 3 mucositis and 4 patients (10%) had grade 4 mucositis. In group 2, only 1 patient (2.5%) was diagnosed with grade 2 mucositis. These data showed no significant differences between group 1 and group 3 (P=0.674), but the therapeutic results of group 2 were significantly better than those of group 3 (P=0.042) and group 1 (P=0.036). CONCLUSION: We showed that treatments with aloe vera mouthwash could be an effective choice in prevention of mucositis for patients undergoing chemotherapy. There are also much to discover about effects of aloe vera mouthwash on this disease.

The necessity for integrating traditional, complementary, and alternative medicine into medical education curricula in Iran.

BACKGROUND: The use of traditional and complementary medicine (T&CM) is increasing in both developed and developing countries. The school of Persian medicine (PM) in Iran is a comprehensive medical school that is rich in history and has its own special principles, elements, philosophy, and diagnostic and treatment options. Many complementary therapy modalities are also popular and in demand among patients and physicians. The aim of this paper is to provide logic for the policymakers in Iranian medical education to make changes in medical education curricula, particularly on integrating T&CM. METHODS: We reviewed the global experience in teaching T&CM to medical students, and highlighting the strengths of PM, described why it is necessary to integrate T&CM into general medicine curricula in Iran. RESULTS: PM is a traditional system of medicine that dates back about 7000 years. Although there are few studies about the safety and effectiveness of PM, research into it has recently been accelerated. There is a suitable opportunity for integrating T&CM with conventional medicine. Physicians should be familiar with T&CM to avoid any contraindications, interactions, and unwanted effects. CONCLUSION: Traditional medicine is part of Iran's heritage and, thus, needs special attention. Familiarization of physicians with T&CM can help them choose the best treatment options for their patients. To integrate T&CM into the medical education curricula of Iran, a two-credit course has been proposed for implementation across the country.