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1.
Medicine (Baltimore) ; 99(33): e21034, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871977

RESUMO

BACKGROUND: The aim of this systematic review and meta-analysis is to assess effectiveness and safety of Chinese medicine (CM) as complementary therapy in treating coronavirus disease 2019 (COVID-19). METHODS: The following databases will be searched: PubMed, Cochrane, Embase, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang database from October 1, 2019 to March 1, 2020. Randomized trials and quasi-randomized or prospective controlled clinical trials of CM that reported data on COVID-19 patients will be included. Study selection, data extraction, quality assessment, and assessment of risk bias will be performed by 2 reviewers independently. Odds ratios and correlative 95% confidence intervals will be calculated to present the association between the CM and CWM using Review Manager version 5.3 when there is sufficient available data. RESULTS: The results will be disseminated through a peer-reviewed journal publication. CONCLUSION: This systematic review findings will summarize up-to-date evidence for that CM is more effective and safe as adjunctive treatment for patients with COVID-19. ETHICS AND DISSEMINATION: Ethics approval and patient consent are not required as this study is a systematic review based on published articles. PROSPERO REGISTRATION NUMBER: CRD42020185382.


Assuntos
Betacoronavirus , Terapias Complementares/métodos , Infecções por Coronavirus/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Pneumonia Viral/terapia , Adulto , Idoso , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Medicina Tradicional Chinesa/métodos , Metanálise como Assunto , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Pneumonia Viral/virologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
2.
Cochrane Database Syst Rev ; 9: CD011216, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32871021

RESUMO

BACKGROUND: Pain after caesarean sections (CS) can affect the well-being of the mother and her ability with her newborn. Conventional pain-relieving strategies are often underused because of concerns about the adverse maternal and neonatal effects. Complementary alternative therapies (CAM) may offer an alternative for post-CS pain. OBJECTIVES: To assess the effects of CAM for post-caesarean pain. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, LILACS, PEDro, CAMbase, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (6 September 2019), and checked the reference lists of retrieved articles. SELECTION CRITERIA: Randomised controlled trials (RCTs), including quasi-RCTs and cluster-RCTs, comparing CAM, alone or associated with other forms of pain relief, versus other treatments or placebo or no treatment, for the treatment of post-CS pain. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, extracted data, assessed risk of bias and assessed the certainty of evidence using GRADE. MAIN RESULTS: We included 37 studies (3076 women) which investigated eight different CAM therapies for post-CS pain relief. There is substantial heterogeneity among the trials. We downgraded the certainty of evidence due to small numbers of women participating in the trials and to risk of bias related to lack of blinding and inadequate reporting of randomisation processes. None of the trials reported pain at six weeks after discharge. Primary outcomes were pain and adverse effects, reported per intervention below. Secondary outcomes included vital signs, rescue analgesic requirement at six weeks after discharge; all of which were poorly reported, not reported, or we are uncertain as to the effect Acupuncture or acupressure We are very uncertain if acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus placebo plus analgesia) has any effect on pain because the quality of evidence is very low. Acupuncture or acupressure plus analgesia (versus analgesia) may reduce pain at 12 hours (standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.64 to 0.07; 130 women; 2 studies; low-certainty evidence) and 24 hours (SMD -0.63, 95% CI -0.99 to -0.26; 2 studies; 130 women; low-certainty evidence). It is uncertain whether acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus analgesia) has any effect on the risk of adverse effects because the quality of evidence is very low. Aromatherapy Aromatherapy plus analgesia may reduce pain when compared with placebo plus analgesia at 12 hours (mean difference (MD) -2.63 visual analogue scale (VAS), 95% CI -3.48 to -1.77; 3 studies; 360 women; low-certainty evidence) and 24 hours (MD -3.38 VAS, 95% CI -3.85 to -2.91; 1 study; 200 women; low-certainty evidence). We are uncertain if aromatherapy plus analgesia has any effect on adverse effects (anxiety) compared with placebo plus analgesia. Electromagnetic therapy Electromagnetic therapy may reduce pain compared with placebo plus analgesia at 12 hours (MD -8.00, 95% CI -11.65 to -4.35; 1 study; 72 women; low-certainty evidence) and 24 hours (MD -13.00 VAS, 95% CI -17.13 to -8.87; 1 study; 72 women; low-certainty evidence). Massage We identified six studies (651 women), five of which were quasi-RCTs, comparing massage (foot and hand) plus analgesia versus analgesia. All the evidence relating to pain, adverse effects (anxiety), vital signs and rescue analgesic requirement was very low-certainty. Music Music plus analgesia may reduce pain when compared with placebo plus analgesia at one hour (SMD -0.84, 95% CI -1.23 to -0.46; participants = 115; studies = 2; I2 = 0%; low-certainty evidence), 24 hours (MD -1.79, 95% CI -2.67 to -0.91; 1 study; 38 women; low-certainty evidence), and also when compared with analgesia at one hour (MD -2.11, 95% CI -3.11 to -1.10; 1 study; 38 women; low-certainty evidence) and at 24 hours (MD -2.69, 95% CI -3.67 to -1.70; 1 study; 38 women; low-certainty evidence). It is uncertain whether music plus analgesia has any effect on adverse effects (anxiety), when compared with placebo plus analgesia because the quality of evidence is very low. Reiki We are uncertain if Reiki plus analgesia compared with analgesia alone has any effect on pain, adverse effects, vital signs or rescue analgesic requirement because the quality of evidence is very low (one study, 90 women). Relaxation Relaxation may reduce pain compared with standard care at 24 hours (MD -0.53 VAS, 95% CI -1.05 to -0.01; 1 study; 60 women; low-certainty evidence). Transcutaneous electrical nerve stimulation TENS (versus no treatment) may reduce pain at one hour (MD -2.26, 95% CI -3.35 to -1.17; 1 study; 40 women; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce pain compared with placebo plus analgesia at one hour (SMD -1.10 VAS, 95% CI -1.37 to -0.82; 3 studies; 238 women; low-certainty evidence) and at 24 hours (MD -0.70 VAS, 95% CI -0.87 to -0.53; 108 women; 1 study; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce heart rate (MD -7.00 bpm, 95% CI -7.63 to -6.37; 108 women; 1 study; low-certainty evidence) and respiratory rate (MD -1.10 brpm, 95% CI -1.26 to -0.94; 108 women; 1 study; low-certainty evidence). We are uncertain if TENS plus analgesia (versus analgesia) has any effect on pain at six hours or 24 hours, or vital signs because the quality of evidence is very low (two studies, 92 women). AUTHORS' CONCLUSIONS: Some CAM therapies may help reduce post-CS pain for up to 24 hours. The evidence on adverse events is too uncertain to make any judgements on safety and we have no evidence about the longer-term effects on pain. Since pain control is the most relevant outcome for post-CS women and their clinicians, it is important that future studies of CAM for post-CS pain measure pain as a primary outcome, preferably as the proportion of participants with at least moderate (30%) or substantial (50%) pain relief. Measuring pain as a dichotomous variable would improve the certainty of evidence and it is easy to understand for non-specialists. Future trials also need to be large enough to detect effects on clinical outcomes; measure other important outcomes as listed lin this review, and use validated scales.


Assuntos
Cesárea/efeitos adversos , Terapias Complementares/métodos , Dor Pós-Operatória/terapia , Acupressão , Analgesia por Acupuntura , Adolescente , Adulto , Analgesia Obstétrica/métodos , Analgésicos/administração & dosagem , Aromaterapia , Viés , Terapia Combinada/métodos , Feminino , Humanos , Massagem , Musicoterapia , Placebos/uso terapêutico , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Relaxamento , Toque Terapêutico , Estimulação Elétrica Nervosa Transcutânea , Adulto Jovem
3.
Medicine (Baltimore) ; 99(30): e21318, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791724

RESUMO

BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases in the world and is showing increasing prevalence in some countries. The disease has a chronic course that leads to a significant decline in the quality of life of patients and is associated with a high economic burden worldwide. And complementary and alternative medicine is used to treat the disease. Over the past few decades, a number of randomized controlled trials and systematic evaluations have been conducted to evaluate the effectiveness and safety of different types of complementary and alternative medicine methods, so there is an urgent need to summarize and further evaluate these studies. METHODS: We will search the following sources without restrictions for date, language, or publication status: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Library, and EMBASE, China National Knowledge Infrastructure, Chinese Bio-medicine Database, VIP Chinese Periodical Database, Wan Fang Database. We will apply a combination of Medical Subject Heading and free-text terms incorporating database-specific controlled vocabularies and text words to implement search strategies. We will also search the ongoing trials registered in the World Health Organization's International Clinical Trials Registry Platform. Besides, the previous relevant reviews conducted on complementary and alternative therapies for GERD and reference lists of included studies will also be searched. RESULTS: This study will provide a reliable basis for the treatment of GERD with complementary and alternative therapies. CONCLUSIONS: The findings will be an available reference to evaluate the efficacy and safety of complementary and alternative therapies on GERD and may provide decision-making reference on which method to choose for clinicians. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42020169332.


Assuntos
Terapias Complementares/efeitos adversos , Refluxo Gastroesofágico/terapia , Metanálise em Rede , Adulto , Idoso , Tomada de Decisão Clínica , Terapias Complementares/métodos , Efeitos Psicossociais da Doença , Bases de Dados Factuais , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/psicologia , Humanos , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(31): e21496, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756183

RESUMO

BACKGROUND: Postpartum depression (PPD) is one of the most common mental disorders in women following childbirth with heightened prevalence across the globe. Both pharmacotherapy and non-pharmacological interventions are effective for PPD. However, due to the concerns about the side effect on the mother and child of pharmacological treatments, most of women with PPD choose non-pharmacological therapies as their first line option. Prescription of these non-drug approaches should be guided by high quality evidence. Therefore, this network meta-analysis aims to compare, rank and interpret existed non-pharmacological evidence for the effective treatment of women with PPD. METHODS: Electronic bibliographic databases including EMBASE, PubMed, Scopus, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI),VIP Database, Wanfang Database and Chinese Biomedical Literature Database will be searched for relevant randomized controlled trials (RCTs) of non-pharmacological interventions for PPD. Heterogeneity and inconsistencies will be analyzed by I statistic and Z test, respectively. We will assess the quality of evidence by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and evaluate the risk of bias according to Cochrane risk of bias tool. R software 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria) will be used to conduct a network meta-analysis. RESULTS: Formal ethical approval is not required, because the present study is a meta-analysis based on existed studies. The findings of this research will be reported in a recognized journal. CONCLUSION: The review results will ascertain the hierarchy of effectiveness of different non-pharmacological approaches for PPD, and systematically provide suggests for physicians and patients. TRIAL REGISTRATION NUMBER: PROSPERO CRD42020166801.


Assuntos
Terapias Complementares/métodos , Depressão Pós-Parto/terapia , Feminino , Humanos , Metanálise em Rede , Gravidez , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(31): e21538, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756205

RESUMO

BACKGROUND: With the increase in the incidence of premature ovarian insufficiency (POI) over the years, the ovarian function has become one of the integral aspects of research in reproductive medicine today. POI seriously affects the physical and mental health of women, especially reproductive health. Studies show both complementary and alternative therapies to be effective in treating POIs. However, consistency in conclusions is still far-fetched. In light of this, we will carry out a study to evaluate the effectiveness and safety of complementary and alternative therapies for POIs. We therefore develop a study protocol for a proposed network meta-analysis (NMA) and systematic review on POI. METHODS: The following electronic bibliographic database will be searched: VIP database, Wanfang database, Chinese National Knowledge Infrastructure (CNKI), The Cochrane Library, PubMed, EMBASE and Web of Science from inception till 31 December 2019. A search at the World Health Organization (WHO) International Clinical Trials Registry Platform will also be done. Subsequently, the searched data will undergo independent screening, retrieving, and risk of bias assessment by 2 reviewers. Analysis will be performed on included studies using the NMA technique. Next, the primary outcomes will be compared using ADDIS 1.16.5 and Stata 15.0. RESULTS: The safety and effectiveness of alternative and complementary therapies used in the treatment of POI will be compared and evaluated. CONCLUSION: This work will provide high-quality evidence for clinicians in the field to build on for best practices in effective interventions (complementary and alternative therapies) for POI. ETHICS AND DISSEMINATION: This NMA is a secondary research which based on some previously published data. Therefore, the ethical approval was not necessary. PROSPERO REGISTRATION NUMBER: CRD42020163873.


Assuntos
Terapias Complementares/métodos , Insuficiência Ovariana Primária/terapia , Adulto , Hormônio Antimülleriano/sangue , Terapias Complementares/efeitos adversos , Estrogênios/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Metanálise em Rede , Projetos de Pesquisa , Adulto Jovem
6.
Niger J Clin Pract ; 23(8): 1054-1060, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788481

RESUMO

Background: Complementary and alternative medicine (CAM) is extensively used in the pediatric population. Environments and the nature of diseases have an impact on the type of CAM therapies used in children. Aims: This study aims to determine the prevalence and determinants of CAM use among Nigerian children living in the Turkish Republic of Northern Cyprus (TRNC). Subjects and Methods: A quantitative, descriptive and cross-sectional study was conducted among 50 parents living in the TRNC. The parents were selected by the snowball sampling technique. Data were collected using a self-administered, NAFKAM International-CAM-Questionnaire (I-CAM-Q). The data were analyzed using SPSS version 20. Chi-square test was used to analyze the associations of CAM use with values of P < 0.05 considered statistically significant. Results: The mean ages of the parents and children were 30 ± 5.56 years and 3 ± 2.17 years, respectively. It was discovered that 34 (68%) out of 50 children had used CAM in the previous 12 months. The most commonly used CAM products were vitamins/minerals (82.4%) and herbs/herbal products (55.9%). While praying for health (61.8%) and relaxation techniques (50.0%) were the most used CAM practices. A majority of the parents perceived that CAM use was beneficial (85.3%). Approximately 10% of the children were prescribed CAM recommendation/treatment by physicians. The most used sources of information were relatives (36%) and friends (14.7%). Parents (58%) indicated that they did not disclose their use of CAMs for their children to a physician/nurse. Conclusions: CAM is used prevalently in this population and the use of CAM is primarily focused on improving well-being. CAM usage for children increases with parental use. Further qualitative research is needed to understand the parental belief in the use of CAMs for children.


Assuntos
Terapias Complementares/estatística & dados numéricos , Vitaminas/administração & dosagem , Adulto , Criança , Pré-Escolar , Terapias Complementares/métodos , Estudos Transversais , Chipre/epidemiologia , Feminino , Amigos , Humanos , Masculino , Nigéria/etnologia , Pais , Médicos , Prevalência , Pesquisa Qualitativa , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
7.
PLoS One ; 15(8): e0237504, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790722

RESUMO

BACKGROUND: Risk perception (RP) describes patient´s judgment of the likelihood of experiencing something unpleasant, and has been associated to the adoption of health behaviors. Current rheumatoid arthritis (RA) guidelines recommend early and intensive treatment, although patients also commonly use Complementary and Alternative Medicine (CAM). We aimed to investigate if significant RP was associated to CAM use in Hispanic RA outpatients and to describe additional associated factors. METHODS: Between March and August 2019, 266 consecutive outpatients were invited to a face-to-face interview to collect socio-demographic and RA-related information, to assess comorbidity and the following patient-reported-outcomes: pain, overall-disease and treatment adherence with visual analogue scales, disease activity with RAPID-3, RP with a validated questionnaire, and CAM use with a translated and cross-culturally adapted for Argentina version of the International CAM questionnaire. Medical records were reviewed to corroborate the data provided by the patients. CAM use definition was restricted to "in the last 3 months". Significant RP was defined based on published cut-off. Multiple logistic regression analysis was used to investigate factors associated to CAM use. The study received IRB approval. RESULTS: There were 246 patients included, primarily middle-aged women, with substantial disease duration, moderate disease activity and 70 patients (28.5%) had significant RP. Two hundreds patients (81.3%) were CAM users. Significant RP (OR: 2.388, 95%CI: 1.044-5.464, p = 0.039) and access to Federal health care system (OR: 2.916, 95%CI: 1.081-7.866, p = 0.035) were associated to CAM use. CONCLUSIONS: Patient´s perception of RA-related negative consequences was associated to recent CAM use in Hispanic RA outpatients.


Assuntos
Artrite Reumatoide/terapia , Terapias Complementares/métodos , Terapias Complementares/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Hispano-Americanos/estatística & dados numéricos , Medição de Risco/métodos , Adulto , Idoso , Argentina , Artrite Reumatoide/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Inquéritos e Questionários
8.
Med Care ; 58 Suppl 2 9S: S116-S124, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32826781

RESUMO

BACKGROUND: Long-term opioid therapy for chronic pain arose amid limited availability and awareness of other pain therapies. Although many complementary and integrative health (CIH) and nondrug therapies are effective for chronic pain, little is known about CIH/nondrug therapy use patterns among people prescribed opioid analgesics. OBJECTIVE: The objective of this study was to estimate patterns and predictors of self-reported CIH/nondrug therapy use for chronic pain within a representative national sample of US military veterans prescribed long-term opioids for chronic pain. RESEARCH DESIGN: National two-stage stratified random sample survey combined with electronic medical record data. Data were analyzed using logistic regressions and latent class analysis. SUBJECTS: US military veterans in Veterans Affairs (VA) primary care who received ≥6 months of opioid analgesics. MEASURES: Self-reported use of each of 10 CIH/nondrug therapies to treat or cope with chronic pain in the past year: meditation/mindfulness, relaxation, psychotherapy, yoga, t'ai chi, aerobic exercise, stretching/strengthening, acupuncture, chiropractic, massage; Brief Pain Inventory-Interference (BPI-I) scale as a measure of pain-related function. RESULTS: In total, 8891 (65%) of 13,660 invitees completed the questionnaire. Eighty percent of veterans reported past-year use of at least 1 nondrug therapy for pain. Younger age and female sex were associated with the use of most nondrug therapies. Higher pain interference was associated with lower use of exercise/movement therapies. Nondrug therapy use patterns reflected functional categories (psychological/behavioral, exercise/movement, manual). CONCLUSIONS: Use of CIH/nondrug therapies for pain was common among patients receiving long-term opioids. Future analyses will examine nondrug therapy use in relation to pain and quality of life outcomes over time.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor Crônica/terapia , Terapias Complementares/estatística & dados numéricos , Medicina Integrativa/estatística & dados numéricos , Veteranos/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/administração & dosagem , Dor Crônica/tratamento farmacológico , Terapias Complementares/métodos , Feminino , Nível de Saúde , Humanos , Medicina Integrativa/métodos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Percepção da Dor , Qualidade de Vida , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos , United States Department of Veterans Affairs , Saúde dos Veteranos
9.
Brasília; Fiocruz Brasília;Instituto de Saúde de São Paulo; ago. 4, 2020. 13 p.
Não convencional em Português | LILACS, Coleciona SUS, MOSAICO - Saúde integrativa, PIE | ID: biblio-1118201

RESUMO

As práticas corporais da Medicina Tradicional Chinesa (MTC) envolvem movimento ou manipulação corporal, atitude mental e respiração com intuito de equilibrar a energia vital-Qi. As práticas da MTC são recomendadas para promoção, manutenção e recuperação da saúde, bem como prevenção de agravos e doenças. As práticas corporais da MTC, no Brasil, incluem acupuntura, lian gong, chi gong(qigong,chi kung);tui-na e tai chi chuan. Estas práticas foram incorporadas no SUS mediante Portaria no 971,de 03 de maio de 2006.PerguntaQualéa eficácia/efetividade e a segurança das práticas corporais da Medicina Tradicional Chinesa(MTC), exceto acupuntura, na cessação do tabagismo em adultos e/ou idosos? As buscas por revisão sistemática foram realizadas em cinco bases de dados sem restrição de ano de publicação, publicados em inglês, português e espanhol. A busca foi por estudos que avaliassem o efeito das práticas corporais na cessação do tabagismo em adultos e idosos. Uma busca adicional por ensaios clínicos randomizados foi realizada em seis bases de dados, respeitando os mesmos critérios de elegibilidade. A acupuntura, embora faça parte das práticas da MTC, não foi incluída porque estás endo analisada separadamente em outras revisões realizadas por esta mesma equipe. De 111 revisões sistemáticas e 1.525 ensaios clínicos recuperados nas bases de dados, nenhum estudo atendeu aos critérios de elegibilidade. Devido à falta de evidências não é possível tecer considerações sobre a eficácia e segurança das práticas de MTC no controle do tabagismo na população adulta.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Tabagismo/prevenção & controle , Terapias Complementares/métodos , Resultado do Tratamento , Abandono do Hábito de Fumar , Medicina Tradicional Chinesa/métodos
10.
Brasília; Fiocruz Brasília;Instituto de Saúde de São Paulo; ago. 3, 2020. 22 p.
Não convencional em Português | LILACS, Coleciona SUS, MOSAICO - Saúde integrativa, PIE | ID: biblio-1118200

RESUMO

As práticas corporais da Medicina Tradicional Chinesa (MTC) envolvem movimento ou manipulação corporal, atitude mental e respiração com intuito de equilibrar o Qi ou energia vital. As práticas da MTC são recomendadas para promoção, manutenção e recuperação da saúde, bem como prevenção de agravos e doenças. As práticas corporais da MTC, no Brasil, incluem acupuntura,lian gong, chi gong (qigong,chi kung); tui-naetai chi chuan. Estas práticas foram incorporadas no SUS mediante Portaria no 971, de 03 de maio de 2006. Qual é a eficácia/efetividade e a segurança das práticas corporais da Medicina Tradicional Chinesa (MTC), exceto acupuntura, no tratamento da obesidade em adultos e/ou idosos? As buscas foram realizadas inicialmente por revisões sistemáticas, mas nenhuma atendeu aos critérios de elegibilidade. Novas buscas foram realizadas em seis bases de dados sem restrição de ano de publicação, para identificar ensaios clínicos randomizados(ECR). Desta forma, foram incluídos ensaios clínicos randomizados em inglês, português e espanhol que avaliaram os efeitos das práticas MTC no tratamento de obesidade na população adulta e idosa. A avaliação da qualidade metodológica foi realizada por meio da ferramenta de risco de viés da Cochrane, feita por uma pesquisadora e revisada por outra. Nesta revisão rápida, produzida em três dias, foram utilizados atalhos metodológicos, de maneira que apenas o processo de seleção foi realizado em duplicidade e de forma independente. A acupuntura, embora faça parte das práticas da MTC, não foi incluída porque está sendo analisada separadamente em outras revisões realizadas por esta mesma equipe. De 1.435 publicações recuperadas nas bases de dados, foram incluídos três ensaios clínicos randomizados que atenderam aos critérios de elegibilidade. A avaliação metodológica dos ECR demonstrou risco de viés, de forma que os resultados devem ser interpretados com cautela. Os estudos mostraram não haver diferença nos resultados entre Taichi e a maioria dos comparadores, com relação aos desfechos IMC, circunferência da cintura, peso corporal, massa corporal, gordura corporal e sensação de fome. O único estudo sobre Qigong não apresentou resultados favoráveis quanto a sua eficácia na redução do peso corporal. Um estudo relatou não ter identificado eventos adversos com a prática de Taichi. Embora existam alguns resultados favoráveis a prática de Taichi, é pequena a evidência de eficácia e segurança da prática no tratamento da obesidade em adultos e idosos. Devido à escassez de evidências não é possível afirmar os reais benefícios do uso dessas tecnologias para o tratamento da obesidade.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Resultado do Tratamento , Tai Ji/métodos , Qigong/métodos , Manejo da Obesidade , Terapias Complementares/métodos , Medicina Tradicional Chinesa/métodos
11.
Medicine (Baltimore) ; 99(28): e21142, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664144

RESUMO

BACKGROUND: Post-traumatic stress disorder (PTSD) is a psychiatric disorder. While bringing psychologic pain to patients, it also damages their social function, which is a great threat to people's life and health. Complementary and alternative medicine (CAM) therapies have been used clinically to treat PTSD; however, the selection strategies of different CAM interventions in clinical practice is still uncertain, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of 7 electronic databases by June 2020. After a series of screening, the 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from randomized controlled trials of CAM therapies for the PTSD. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of CAM therapies for PTSD. CONCLUSION: The results of this study will provide references for evaluating the influence of different CAM therapies for PTSD, and provide decision-making references for clinical research.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapias Complementares/métodos , Metanálise em Rede , Transtornos de Estresse Pós-Traumáticos/terapia , Humanos
12.
Medicine (Baltimore) ; 99(28): e21219, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664174

RESUMO

BACKGROUND: The incidence of ulcerative colitis (UC) is increasing year by year worldwide, and it is listed as one of the refractory diseases by World Health Organization. In addition to typical intestinal manifestations such as abdominal pain, diarrhea, mucus, pus, and bloody stool, it can also accompany multiorgan and multisystem extraintestinal manifestations, seriously affecting the life and work of patients. Furthermore, UC patients with a tremendous psychological pressure and affects their physical and mental health. In recent years, many complementary and alternative therapies have been used for treatment of UC, but only pair-wised drugs have been evaluated in the traditional meta-analyses and some results are inconsistent. Consequently, it is essential to propose a protocol for systematic review and meta-analysis to discuss the efficacy and safety of complementary and alternative therapies in the treatment of UC. METHODS: We will search Chinese and English databases comprehensively and systematically from the establishment of databases to May 2020, free of language or publication restrictions. All randomized controlled trials on complementary and alternative therapies for UC will be included. Two researchers will independently screen titles, abstracts, full texts, and extract data, then assess the bias risk of each study. We will conduct pairwise meta-analyses and Bayesian network meta-analyses to the relative outcomes of the efficacy and safety. Data analysis will use STATA and WinBUGs 1.4.3 software in this meta-analysis. RESULTS: This study will evaluate the efficacy and safety of complementary and alternative therapies for UC based on changes in symptoms, clinical efficacy, quality of life and adverse events. CONCLUSION: This study will provide evidence for whether complementary and alternative therapies are beneficial to the treatment of UC. In order to provide reliable evidence-based medicine for clinical practice. INPLASY REGISTRATION NUMBER: INPLASY202060015.


Assuntos
Colite Ulcerativa/terapia , Terapias Complementares/métodos , Adulto , Teorema de Bayes , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Humanos , Masculino , Metanálise em Rede , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
13.
Med Care ; 58(8): 689-695, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32692134

RESUMO

BACKGROUND: Although complementary and alternative medicine (CAM) has been associated with reduced morbidity among adults with chronic back pain, less is known about the association between CAM use and health care expenditures. OBJECTIVES: The objective of this study was to first estimate health care expenditures of adult CAM users and nonusers with chronic back pain and then assess CAM's influence on health care expenditures. RESEARCH DESIGN: This was an ambidirectional cohort study. DATA: Linked National Health Interview Survey (2012) and Medical Expenditure Panel Survey (2013-2014). MEASURES: CAM use was defined as 3 or more visits to a practitioner in the 12 months before the National Health Interview Survey interview. Covariates included age, sex, race-ethnicity, and body mass index. The outcome was annual health care expenditures (overall and within 8 categories, including office-based visits and prescription medication). ANALYSES: Survey-weighted, covariate adjusted predicted marginal means models were applied to quantify health care expenditures. Survey-weighted, covariate adjusted linear and logistic regression models were used to investigate CAM's influence on expenditures, and the Z mediation test statistic was applied to quantify the independent effects of CAM. RESULTS: Overall, health care expenditures were significantly lower among CAM users with chronic back pain compared with non-CAM users for both 2013 and 2014: $8402 versus $9851 for 2013; $7748 versus $10,227 in 2014, annual differences of -$1499 (95% confidence interval: -$1701 to -$1197) and -$2479 (95% confidence interval: -$2696 to -$2262), respectively (P<0.001). Adult CAM users also had significantly lower prescription medication as well as outpatient expenses (P<0.001). CAM use was identified as a partial mediator to health care expenditures. CONCLUSION: CAM use is associated with lower overall health care expenditures, driven primarily by lower prescription and outpatient expenditures, among adults with chronic back pain in the United States.


Assuntos
Dor nas Costas/economia , Terapias Complementares/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Dor nas Costas/terapia , Estudos de Coortes , Terapias Complementares/métodos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
14.
Diabetes Res Clin Pract ; 166: 108311, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32673699

RESUMO

Complementary medicine (CM) treatment beliefs of people with type 2 diabetes were assessed using a validated three-domain questionnaire. Belief in holistic health, but not natural treatments or participation in treatment, was independently associated with CM use (P = 0.003). Strong holistic health beliefs could identify present/future CM use, with potential management implications.


Assuntos
Terapias Complementares/métodos , Diabetes Mellitus Tipo 2/terapia , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Feminino , Humanos , Masculino
15.
Indian J Public Health ; 64(Supplement): S105-S107, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-555434

RESUMO

There is a lot of discussion on COVID-19 control strategies from the mainstream approaches, but it is also necessary to examine the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) sector, which is now being brought into public health interventions nationally. Although the AYUSH sector had previously joined the management of dengue and chikungunya outbreaks in some Indian states, its participation has remained contentious and there is reluctance in mainstream public health discourses to seriously examine their interventions. This is a commentary on the efforts made by the Ministry of AYUSH, state AYUSH directorates, AYUSH research institutions, and public hospitals, based on official documents as well as official statements reported in the media, with the aim of bringing out concerns in the process of adapting traditional textual knowledge and practices to public health requirements of the current age.


Assuntos
Terapias Complementares/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Betacoronavirus , Homeopatia/métodos , Humanos , Índia/epidemiologia , Medicina Ayurvédica/métodos , Naturopatia/métodos , Pandemias , Ioga
17.
Indian J Public Health ; 64(Supplement): S105-S107, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496237

RESUMO

There is a lot of discussion on COVID-19 control strategies from the mainstream approaches, but it is also necessary to examine the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) sector, which is now being brought into public health interventions nationally. Although the AYUSH sector had previously joined the management of dengue and chikungunya outbreaks in some Indian states, its participation has remained contentious and there is reluctance in mainstream public health discourses to seriously examine their interventions. This is a commentary on the efforts made by the Ministry of AYUSH, state AYUSH directorates, AYUSH research institutions, and public hospitals, based on official documents as well as official statements reported in the media, with the aim of bringing out concerns in the process of adapting traditional textual knowledge and practices to public health requirements of the current age.


Assuntos
Terapias Complementares/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Betacoronavirus , Homeopatia/métodos , Humanos , Índia/epidemiologia , Medicina Ayurvédica/métodos , Naturopatia/métodos , Pandemias , Ioga
18.
Neurology ; 94(21): e2203-e2212, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32376640

RESUMO

OBJECTIVE: To evaluate the effectiveness of yoga as an adjuvant to conventional medical management on clinical outcomes in patients with migraine. METHODS: CONTAIN was a prospective, randomized, open-label superiority trial with blinded endpoint assessment carried out at a single tertiary care academic hospital in New Delhi, India. Patients enrolled were aged 18-50 years with a diagnosis of episodic migraine and were randomized into medical and yoga groups (1:1). Randomization was computer-generated with a variable block size and concealed. A predesigned yoga intervention was given for 3 months. Outcomes were recorded by a blinded assessor. The primary endpoint was a decrease in headache frequency, headache intensity, and Headache Impact Test (HIT)-6 score. Secondary outcomes included change in Migraine Disability Assessment (MIDAS) score, pill count, and proportion of headache free patients. RESULTS: Between April 2017 and August 2018, 160 patients with episodic migraine were randomly assigned to medical and yoga groups. A total of 114 patients completed the trial. Baseline measures were comparable except for a higher mean headache frequency in the yoga group. Compared to medical therapy, the yoga group showed a significant mean delta value reduction in headache frequency (delta difference 3.53 [95% confidence interval 2.52-4.54]; p < 0.0001), headache intensity (1.31 [0.60-2.01]; p = 0.0004), HIT score (8.0 [4.78-11.22]; p < 0.0001), MIDAS score (7.85 [4.98-10.97]; p < 0.0001), and pill count (2.28 [1.06-3.51]; p < 0.0003). CONCLUSION: Yoga as an add-on therapy in migraine is superior to medical therapy alone. It may be useful to integrate a cost-effective and safe intervention like yoga into the management of migraine. CLINICALTRIALSGOV IDENTIFIER: CTRI/2017/03/008041. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with episodic migraine, yoga as adjuvant to medical therapy improves headache frequency, intensity, impact, and disability.


Assuntos
Terapias Complementares/métodos , Transtornos de Enxaqueca/terapia , Ioga , Adolescente , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
19.
Complement Ther Clin Pract ; 39: 101171, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32379696

RESUMO

BACKGROUND: Acute respiratory tract infection (ARTI) is a prevalent condition associated with serious health and economic implications. A range of strategies is used to manage ARTI in children, including complementary and alternative medicines (CAM). There has been little investigation into this area, and this study aims to address this knowledge gap. METHODS: Primary carers of children aged from 0 to 12 years that utilised CAM for ARTI were invited to participate in the online survey in 2019. Survey data were analysed descriptively. RESULTS: The 246 surveyed parents specified the types of CAM frequently used to manage ARTI in their children were home-remedies. Reasons parents reported using CAM were personal-beliefs and positive past-experience with CAM practitioners. Information sources that parents consulted when decision-making were education, naturopaths, and journals. CONCLUSION: Parents utilised diverse interventions, with home-remedies dominating the choice. Parents were most likely well-informed. Notably, parents indicated a preference for an integrative healthcare approach.


Assuntos
Doença Aguda/terapia , Terapias Complementares/métodos , Terapias Complementares/psicologia , Grupos de Populações Continentais/psicologia , Pais/psicologia , Infecções Respiratórias/terapia , Adulto , Austrália/epidemiologia , Criança , Pré-Escolar , Terapias Complementares/estatística & dados numéricos , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Infecções Respiratórias/epidemiologia , Inquéritos e Questionários
20.
Urologe A ; 59(6): 695-699, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32270244

RESUMO

Modern concepts such as patient empowerment stand for the selection of appropriate concomitant treatment procedures from a scientific point of view and for placing these in the hands of the patient, thereby demanding and encouraging personal responsibility. It is important to distinguish between the terms complementary and/or alternative medicine. If we look at the motivation of patients to use complementary and/or alternative procedures, this is divided into the desire to do something directly against the tumor and on the other hand to strengthen the body's own resources, support the immune system, and reduce side effects in a concrete manner. The crux of modern oncology is that many specialists no longer have sufficient time for detailed patient information talks and multiple good physician-patient talks. The importance of complementary medicine in addition to nutrition and exercise lies above all in its targeted use as a concomitant supportive therapy. Complementary medicine primarily offers the chance to meet the desire of those affected to actively participate in their treatment.


Assuntos
Terapias Complementares/métodos , Neoplasias Urogenitais/terapia , Humanos , Oncologia/tendências , Participação do Paciente , Relações Médico-Paciente
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