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Tsai MY, Huang YC, Cheng BC, Chin CY, Hsu YT, Lee WC. Prevalence and varieties of complementary and alternative medicine usage among individuals with pre-dialysis chronic kidney disease in Taiwan: an investigative cross-sectional analysis. BMC Complement Med Ther 2024; 24:11. [PMID: 38167149 PMCID: PMC10759758 DOI: 10.1186/s12906-023-04311-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is frequently used in the general population, yet only limited data are available regarding the prevalence of these medications in patients with chronic kidney disease (CKD). Hence, our study aimed to explore the prevalence and types of CAM in Taiwanese patients with CKD. METHODS A cross-sectional questionnaire survey was conducted by face-to-face interview of 275 pre-dialysis patients without dialysis treatment or kidney transplant at an outpatient nephrology clinic in Taiwan from March 2021 to June 2023. The study outcomes were the prevalence of CAM, CAM types, reasons for using CAM, and sources of information about CAM. RESULTS Overall, 128 patients (46.5%) were using CAM, but no significant differences from non-CAM users in the various CKD stages (p = 0.156) were found. CAM usage was high in the age range of 20-60 years and duration of CKD ≤ 5 years (p < 0.05). The most commonly used type of CAM was nutritional approaches (79.7%), followed by other complementary health approaches (26.6%). The most commonly utilized modalities of CAM were vitamins and minerals (38.3%), and only 27.1% of patients disclosed their CAM use to their physicians. The most common sources of information about CAM were family and friends, cited by 66% of the participants. Health promotion and a proactive attitude were reported by 40% of users as the reasons for using CAM. CONCLUSIONS The present study provides data on the CAM usage among CKD patients and adds to the increasing evidence on CAM use. Because some of these practices have safety concerns, better education from healthcare providers on the risks and benefits of CAM therapy is needed by CKD patients.
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Affiliation(s)
- Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and, Chang Gung University College of Medicine, No. 123 Dapi Rd., Niaosong Dist., Kaohsiung, 83301, Taiwan.
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, 41354, Taiwan
| | - Ben-Chung Cheng
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Chieh-Ying Chin
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and, Chang Gung University College of Medicine, No. 123 Dapi Rd., Niaosong Dist., Kaohsiung, 83301, Taiwan
- Department of Nursing, MeiHo University, Pingtung, 912009, Taiwan
- Kaohsiung Municipal Feng Shan Hospital-Under the management of Chang Gung Medical Foundation, Kaohsiung, 830025, Taiwan
| | - Yung-Tang Hsu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and, Chang Gung University College of Medicine, No. 123 Dapi Rd., Niaosong Dist., Kaohsiung, 83301, Taiwan
| | - Wen-Chin Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.
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Jia X, Zhang X, Yan M, Sun D, Li R, Yang N, Luo Z. Increased TG to HDL-C ratio is associated with severity of drug-induced liver injury. Sci Rep 2023; 13:6897. [PMID: 37106083 PMCID: PMC10140261 DOI: 10.1038/s41598-023-34137-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
We investigated the relationship between dyslipidemia and drug-induced liver injury (DILI), especially the level of triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) in severe DILI. In this single-centered retrospective study, of 326 patients with DILI, 221 patients were analyzed. Control groups include medication using group and acute hepatitis B group. The relationship between dyslipidemia and DILI was estimated. Demographic and clinical features were analyzed. Dyslipidemia and TG/HDL-C ratios were compared between DILI and control groups, DILI mild group and severe group. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the credibility of the relationship and to find cut-off points. Dyslipidemia is related to DILI when compared with medication using control group (AOR 4.60; 95% CI 2.81-7.54; P < 0.01) and compared with acute hepatitis B group (AOR 2.12; 95% CI 1.37-3.29; P < 0.01). Dyslipidemia is associated with the severity of DILI (AOR 25.78; 95% CI 7.63-87.1; P < 0.01). TG/HDL-C ratio is higher in DILI group than that of medication using control group, also higher in severe DILI group than that of mild DILI group. AUCs for TG/HDL-C ratio to indicate the severity of DILI was 0.89 (P < 0.05), the cut-off point was 2.35. Dyslipidemia and TG/HDL-C ratio were related to DILI occurrence. Severe liver injury in DILI was associated with dyslipidemia and elevated TG/HDL-C ratio.
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Affiliation(s)
- Xiaoqing Jia
- Department of Gastroenterology, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xiaoting Zhang
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ming Yan
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Dalong Sun
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Rong Li
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Na Yang
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Zheng Luo
- Department of Geriatric Medicine, Qilu Hospital, Shandong University, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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Kang D, Dong H, Shen Y, Ou J, Zhao J. The clinical application of Chinese herbal medication to depression: A narrative review. Front Public Health 2023; 11:1120683. [PMID: 36969689 PMCID: PMC10034025 DOI: 10.3389/fpubh.2023.1120683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Depression severely impairs psychosocial functioning and quality of life, which places a huge burden on patients and their families. However, the physiological mechanism of depression remains unknown. Treatment with existing antidepressant medications is effective in around 50% of patients according to various studies, but is associated with severe side effects including nausea and headaches. Chinese herbal medicine (CHM) has been approved and widely used for depression as an alternative medicine in Chinese culture for decades. It has certain advantages and potential in the prevention and treatment of depression. In this review, we summarize the currently available evidence for the efficacy of CHM for the treatment of depression and physiological diseases comorbid with depression. We further discuss the possible mechanisms of action of CHM and the relationships to our current understanding of depression. The majority of current evidence has suggested that the combined treatment with CHM and mainstream antidepressants improves the response rate and reduces the side effects, while CHM alone could be more effective than placebo. However, the results should be carefully interpreted due to the shortcomings of existing clinical trials and a high risk of bias in meta-analyses. Our review provides a summary of the current applications and understanding of widely used CHMs for depression.
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Affiliation(s)
- Dongyu Kang
- Department of Psychiatry and Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
| | - Huixi Dong
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yidong Shen
- Department of Psychiatry and Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
- *Correspondence: Yidong Shen
| | - Jianjun Ou
- Department of Psychiatry and Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
- Jianjun Ou
| | - Jingping Zhao
- Department of Psychiatry and Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
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Tsai ST, Nithiyanantham S, Satyanarayanan SK, Su KP. Anti-Inflammatory Effect of Traditional Chinese Medicine on the Concept of Mind-Body Interface. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:435-458. [PMID: 36949321 DOI: 10.1007/978-981-19-7376-5_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
In this chapter, we conducted a systemic literature review for the anti-inflammatory effects of Traditional Chinese Medicine (TCM) applying molecular mechanisms focusing on the neuroinflammation and gut-brain axis in three neuropsychiatric disorders: major depressive disorder, Alzheimer's disease, and Parkinson's disease. We demonstrated the anti-inflammation or immunomodulation effects of TCM, including acupuncture, from basic and clinical research, including cellular and molecular approaches. In conclusion, inflammation plays a critical role in the neuropsychopathological process. At the same time, anti-inflammation seems to be the common biological pathway for the effects of TCM and acupuncture in depression, Alzheimer's disease, and Parkinson's disease.
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Affiliation(s)
- Sheng-Ta Tsai
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Srinivasan Nithiyanantham
- Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
| | - Senthil Kumaran Satyanarayanan
- Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan.
- Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.
- An-Nan Hospital, China Medical University, Tainan, Taiwan.
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Lu MC, Lo HC, Chang HH, Hsu CW, Koo M. Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study. BMC Complement Med Ther 2021; 21:247. [PMID: 34598699 PMCID: PMC8485480 DOI: 10.1186/s12906-021-03416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022] Open
Abstract
Background This study aimed to investigate the prevalence of and the factors associated with the regular use of complementary therapies for Taiwanese patients with systemic lupus erythematosus (SLE). Methods In this cross-sectional study, 351 patients with SLE were consecutively recruited from a regional hospital in southern Taiwan from April to August 2019. Demographic and clinical information, including the use of different types of complementary therapies, was ascertained using a self-constructed questionnaire. Disease-specific quality of life was measured using the Lupus Quality of Life (LupusQoL) questionnaire. SLE disease activity was assessed using the rheumatologist-scored Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Factors associated with the regular use of complementary therapies were evaluated using multiple logistic regression analyses. Results Of the 351 patients with SLE, 90.3% were female, and 60.1% were ≥ 40 years of age. The prevalence of the regular use of any type of complementary therapy was 85.5%. The five most popular types of complementary therapy used were (1) fitness walking or strolling, (2) Buddhist prayer or attending temple, (3) vitamin consumption, (4) calcium supplementation, and (5) fish oil supplementation. Multiple logistic regression analyses revealed that the significant and independent factors associated with the regular use of complementary therapies in patients with SLE were age ≥ 40 years (adjusted odds ratio [aOR] 2.76, p = 0.013), nonoverweight or nonobesity (aOR 0.29, p = 0.004), engagement in vigorous exercise in the past year (aOR 4.62, p = 0.002), a lower SLEDAI-2 K score (aOR 0.90, p = 0.029), and a lower score in the physical health domain of the LupusQoL (aOR 0.57, p = 0.001). Conclusions A high prevalence of complementary therapy use in Taiwanese patients with SLE was observed. Rheumatologists should routinely ask patients about their use of supplements to minimize the risk of interaction with medical therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03416-w.
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Affiliation(s)
- Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Hui-Chin Lo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Hsiu-Hua Chang
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Chia-Wen Hsu
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien, 970302, Taiwan. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Cheng VYW, Huang CM, Liao JY, Hsu HP, Wang SW, Huang SF, Guo JL. Combination of 3-Dimensional Virtual Reality and Hands-On Aromatherapy in Improving Institutionalized Older Adults' Psychological Health: Quasi-Experimental Study. J Med Internet Res 2020; 22:e17096. [PMID: 32706660 PMCID: PMC7428146 DOI: 10.2196/17096] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/08/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Abstract
Background In Taiwan, which has one of the most rapidly aging populations in the world, it is becoming increasingly critical to promote successful aging strategies that are effective, easily usable, and acceptable to institutionalized older adults. Although many practitioners and professionals have explored aromatherapy and identified its psychological benefits, the effectiveness of combining 3-dimensional (3D) virtual reality and hands-on aromatherapy remains unknown. Objective A quasi-experimental trial was designed to evaluate the effectiveness of this combination in lowering perceived stress and promoting happiness, sleep quality, meditation experience, and life satisfaction among institutionalized older adults in Taiwan. Methods A total of 60 institutionalized elderly participants either received the combined intervention or were in a control group. Weekly 2-hour sessions were implemented over 9 weeks. The outcome variables were happiness, perceived stress, sleep quality, meditation experience, and life satisfaction, which were assessed at baseline and after the intervention. Results Generalized estimating equation (GEE) analyses indicated that the experimental group showed significant post-intervention improvements in terms of scores for happiness, perceived stress, sleep quality, meditation experience, and life satisfaction (n=48; all P<.001). Another GEE analysis showed that the significant improvements in the 5 outcome variables persisted in participants aged 80 years and older (n=35; all P<.001). Conclusions This is the first trial to explore the effectiveness of a combination of 3D virtual reality and hands-on aromatherapy in improving older adults’ psychological health. The results are promising for the promotion of psychological health in institutionalized older adults. Trial Registration ClinicalTrials.gov NCT04324216; https://clinicaltrials.gov/ct2/show/NCT04324216.
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Affiliation(s)
| | - Chiu-Mieh Huang
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Jung-Yu Liao
- Institute of Population Health sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Hsiao-Pei Hsu
- Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Wen Wang
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
| | - Su-Fei Huang
- Department of Senior Citizen Service, Mackay Junior College of Medicine, Taipei, Taiwan
| | - Jong-Long Guo
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
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Huang CW, Tran DNH, Li TF, Sasaki Y, Lee JA, Lee MS, Arai I, Motoo Y, Yukawa K, Tsutani K, Ko SG, Hwang SJ, Chen FP. The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q). J Chin Med Assoc 2019; 82:665-671. [PMID: 31305349 DOI: 10.1097/jcma.0000000000000131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT). METHODS I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community. RESULTS Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months. CONCLUSION Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.
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Affiliation(s)
- Ching-Wen Huang
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Diem Ngoc Hong Tran
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Tsai-Feng Li
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Yui Sasaki
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ju Ah Lee
- Hwa-pyeong Institute of Integrative Medicine, Incheon, South Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ichiro Arai
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Yoshiharu Motoo
- Department of Medical Oncology, Kanazawa Medical University, Ishikawa, Japan
| | - Keiko Yukawa
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan
| | - Kiichiro Tsutani
- Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Seong-Gyu Ko
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Family Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Fang-Pey Chen
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Proteomic Analysis of the Antidepressant Effects of Shen–Zhi–Ling in Depressed Patients: Identification of Proteins Associated with Platelet Activation and Lipid Metabolism. Cell Mol Neurobiol 2018; 38:1123-1135. [DOI: 10.1007/s10571-018-0582-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 03/16/2018] [Indexed: 12/12/2022]
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Levy I, Attias S, Ben-Arye E, Schiff E. Use and safety of dietary and herbal supplements among hospitalized patients: What have we learned and what can be learned?—A narrative review. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, French SD. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap 2017; 25:35. [PMID: 29201346 PMCID: PMC5698931 DOI: 10.1186/s12998-017-0165-8] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022] Open
Abstract
Background Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Methods Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition. Results The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). Conclusions This comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.
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Affiliation(s)
| | - Jessica J. Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Deborah A. Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
| | - Nir Ben Simon
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - André E. Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, Canada
| | - Silvano A. Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Simon D. French
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
- Department of Chiropractic, Macquarie University, Sydney, Australia
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Wang Y, Huang M, Lu X, Wei R, Xu J. Ziziphi spinosae lily powder suspension in the treatment of depression-like behaviors in rats. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:238. [PMID: 28454575 PMCID: PMC5410100 DOI: 10.1186/s12906-017-1749-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/21/2017] [Indexed: 01/12/2023]
Abstract
Background Depression is a chronic, recurring and potentially life-threatening illness. Current treatments for depression are characterized by a low success rate and associated with a wide variety of side effects. The aim of the present study was to evaluate the behavioral anti-depressant effect of a novel herbal compounds named ziziphi spinosae lily powder suspension, as well as to investigate its potential mechanisms. Methods Except for body weight, depressive-like behaviors were also evaluated using forced swimming test, sucrose consumption test and open field test. In order to investigate the underlying potential mechanisms, serum 5-HT and brain 5-HIAA were measured using ultrahigh-performance liquid chromatography and high-performance liquid chromatography, respectively. Results Results showed that the herbal compounds ziziphi spinosae lily suspension could alleviate depressive symptoms in rat model of chronic depression. Biochemical analysis revealed that the herbal compounds elevated serum 5-HT and brain 5-HIAA. Conclusion Ziziphi spinosae lily powder suspension could alleviate depressive behaviors in depression model animals. The underlying mechanisms may be related to the increase of serum 5-HT in peripheral blood and 5-HIAA in brain. The study provides important mechanistic insights into the protective effect of the herbal compounds against chronic depressive disorder and suggests that the herbal compounds may be a potential pharmacological agent for treatment of major depressive disorder. Electronic supplementary material The online version of this article (doi:10.1186/s12906-017-1749-5) contains supplementary material, which is available to authorized users.
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Liao YC, Chou CY, Chang CT, Li TC, Sun MF, Chang HH, Tsai FJ, Yen HR. Qi deficiency is associated with depression in chronic hemodialysis patients. Complement Ther Med 2016; 30:102-106. [PMID: 28137519 DOI: 10.1016/j.ctim.2016.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/28/2016] [Accepted: 12/24/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Depression is a common bio-psycho-social problem in hemodialysis (HD) patients. Traditional Chinese medicine has been used for symptom management in patients with depression. Identification of the specific constitution in traditional Chinese medicine is critical for personalized care. However, the association between depression and specific constitution in HD patients is unknown. METHODS We conducted a cross-sectional study in all chronic HD patients (HD for more than 3 months) at China Medical University Hospital in Taiwan. The depression symptom severity was determined using the Beck Depression Inventory II (BDI-II). Clinical patterns in Chinese medicine were determined using the Constitution in Chinese Medicine Questionnaire. The association between constitution and depression was analyzed using logistic regression. RESULTS We recruited 467 chronic hemodialysis patients, including 219 females and 248 males, with a mean age of 63±12years. The mean duration of HD was 5.8 years. The mean score for the BDI-II was 11 (interquartile range 8-14). The major constitution was Yang-deficiency (43.7%) among these chronic HD patients. Qi-deficiency was correlated with a duration of HD of more than 5.8 years (p=0.04). Qi-deficiency [odds ratio (OR): 4.05, 95% confidence interval (CI): 1.69-9.72, p<0.01] was also associated with depression in logistic regression with adjustments for confounders, including calcium, phosphorus and hemoglobin levels. CONCLUSION Qi-deficiency constitution in Chinese medicine is associated with depression in chronic HD patients. Further studies are needed to determine whether treating Qi-deficiency integrating Chinese medicine treatment can improve patients' depression symptoms.
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Affiliation(s)
- Yuan-Ching Liao
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Che-Yi Chou
- Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chiz-Tzung Chang
- Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, 404, Taiwan
| | - Mao-Feng Sun
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Hen-Hong Chang
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan
| | - Hung-Rong Yen
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research and Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan.
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Quantitative proteomics analysis of the liver reveals immune regulation and lipid metabolism dysregulation in a mouse model of depression. Behav Brain Res 2016; 311:330-339. [PMID: 27247144 DOI: 10.1016/j.bbr.2016.05.057] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 11/20/2022]
Abstract
Major depressive disorder (MDD) is a highly prevalent and debilitating mental illness with substantial impairments in quality of life and functioning. However, the pathophysiology of major depression remains poorly understood. Combining the brain and body should provide a comprehensive understanding of the etiology of MDD. As the largest internal organ of the human body, the liver has an important function, yet no proteomic study has assessed liver protein expression in a preclinical model of depression. Using the chronic unpredictable mild stress (CUMS) mouse model of depression, differential protein expression between CUMS and control (CON) mice was examined in the liver proteome using isobaric tag for relative and absolute quantitation (iTRAQ) coupled with tandem mass spectrometry. More than 4000 proteins were identified and 66 most significantly differentiated proteins were used for further bioinformatic analysis. According to the ingenuity pathway analysis (IPA), we found that proteins related to the inflammation response, immune regulation, lipid metabolism and NFκB signaling network were altered by CUMS. Moreover, four proteins closely associated with these processes, hemopexin, haptoglobin, cytochrome P450 2A4 (CYP2A4) and bile salt sulfotransferase 1 (SULT2A1), were validated by western blotting. In conclusion, we report, for the first time, the liver protein expression profile in the CUMS mouse model of depression. Our findings provide novel insight (liver-brain axis) into the multifaceted mechanisms of major depressive disorder.
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Chen YL, Lee CY, Huang KH, Kuan YH, Chen M. Prescription patterns of Chinese herbal products for patients with sleep disorder and major depressive disorder in Taiwan. JOURNAL OF ETHNOPHARMACOLOGY 2015; 171:307-316. [PMID: 26068429 DOI: 10.1016/j.jep.2015.05.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/27/2015] [Accepted: 05/29/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Chinese herbal products (CHPs) are commonly prescribed for sleep disorder and major depressive disorder (MDD). The aim of this study was to investigate the prescription patterns of CHPs and Western medicine for patients with these disorders in Taiwan, and analyze the frequency of using single herbs (SHs) and herbal formulas (HFs). MATERIALS AND METHODS In this retrospective population-based study secondary data analysis was performed using data from Taiwan's Longitudinal Health Insurance Database (LHID) between January 2007 and December 2011. In total, 1000,000 beneficiaries from the LHID were randomly selected from the 2010 registry for beneficiaries of the National Health Insurance Research Database. Patients with sleep disorder and MDD according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes 307.40 and 311, respectively. RESULTS Among a total of 11,030 patients with sleep disorder, 9619 used Western medicine, 1334 used CHPs, and 77 used both, Among a total of 11,571 patients with MDD, 11,389 used Western medicine, 131 used CHPs, and 51 used both. Regardless of disorder type, women were predominant The majority of the patients were aged 22-44 years, had a monthly income of NT$17,281-NT$22,800, and lived in an area with Level 1 and Level 2 urbanization. Of the patients with sleep disorder, 1411 had used CHPs and visited a clinic 5298 times on average. Of the patients with MDD, 182 had used CHPs and visited a clinic 755 times on average. The three most commonly used SHs and HFs were Ziziphi Spinosae Semen, Polygoni Multiflori Caulis, and Polygalae Radix, and Jia-Wei-Xiao-Yao-San, Suan-Zao-Ren-Tang, and Chai-Hu-Chia-Lung-Ku-Mu-Li-Tang, respectively. CONCLUSION Chinese herbal products including SHs and HFs are prescribed for patients with sleep disorder and MDD. However, the efficacy and safety of CHPs for sleep disorder and MDD need to be further evaluated.
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Affiliation(s)
- Yi-Lin Chen
- Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China
| | - Chien-Ying Lee
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Kuang-Hua Huang
- Department of Health Service Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming Chen
- Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China.
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Prescription of Chinese Herbal Medicine in Pattern-Based Traditional Chinese Medicine Treatment for Depression: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:160189. [PMID: 26180532 PMCID: PMC4477207 DOI: 10.1155/2015/160189] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 09/21/2014] [Indexed: 11/17/2022]
Abstract
Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses. A systematic review of randomized controlled trials in Chinese and English literatures on TCM pattern-based treatment for depression has therefore been conducted. A total of 61 studies, 2504 subjects, and 27 TCM patterns were included. Due to the large variation of TCM pattern among participants, we only analyzed the top four commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart, and spleen and liver depression and qi stagnation. We found that Xiaoyao decoction was the most frequently used herbal formula for the treatment of liver qi depression and liver depression with spleen deficiency, while Chaihu Shugan decoction was often used for liver depression and qi stagnation. Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas. The rationale underlying herb selection was seldom provided. Due to the limited number of studies on TCM pattern-based treatment of depression and their low methodological quality, we are unable to draw any conclusion regarding which herbal formulas have higher efficacy and which TCM patterns respond better to CHM.
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Gyasi RM, Siaw LP, Mensah CM. Prevalence and pattern of traditional medical therapy utilisation in Kumasi Metropolis and Sekyere South District, Ghana. JOURNAL OF ETHNOPHARMACOLOGY 2015; 161:138-146. [PMID: 25523371 DOI: 10.1016/j.jep.2014.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Whilst over three-quarters of the world׳s population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana. MATERIALS AND METHODS A sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fisher's exact tests from the PASW (V.17.0) with p ≤ 0.05 as significant. RESULTS The survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs׳ consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001). CONCLUSION Concomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Scheme's drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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Liu L, Liu C, Wang Y, Wang P, Li Y, Li B. Herbal Medicine for Anxiety, Depression and Insomnia. Curr Neuropharmacol 2015; 13:481-93. [PMID: 26412068 PMCID: PMC4790408 DOI: 10.2174/1570159x1304150831122734] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/11/2015] [Accepted: 01/23/2015] [Indexed: 12/15/2022] Open
Abstract
The prevalence and comorbidity of psychiatric disorders such as depression, anxiety and insomnia are very common. These well-known forms of psychiatric disorders have been affecting many people from all around the world. Herb alone, as well as herbal formula, is commonly prescribed for the therapies of mental illnesses. Since various adverse events of western medication exist, the number of people who use herbs to benefit their health is increasing. Over the past decades, the exploration in the area of herbal psychopharmacology has received much attention. Literatures showed a variety of herbal mechanisms of action used for the therapy of depression, anxiety and insomnia, involving reuptake of monoamines, affecting neuroreceptor binding and channel transporter activity, modulating neuronal communication or hypothalamic-pituitary adrenal axis (HPA) etc. Nonetheless, a systematic review on herbal pharmacology in depression, anxiety and insomnia is still lacking. This review has been performed to further identify modes of action of different herbal medicine, and thus provides useful information for the application of herbal medicine.
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Affiliation(s)
- Lei Liu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun 130024, China
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
| | - Changhong Liu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun 130024, China
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
| | - Yicun Wang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun 130024, China
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
| | - Pu Wang
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
| | - Yuxin Li
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
| | - Bingjin Li
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, Second Hospital of Jilin University, Changchun 130024, China
- Life Sciences Institute, Northeast Normal University, Changchun, China 130024
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A systematic review on the efficacy, safety and types of Chinese herbal medicine for depression. J Psychiatr Res 2014; 57:165-75. [PMID: 24974002 DOI: 10.1016/j.jpsychires.2014.05.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/05/2014] [Accepted: 05/28/2014] [Indexed: 11/23/2022]
Abstract
Chinese herbal medicine (CHM) is one of the commonly used complementary and alternative medicine therapies for major depressive disorder. The objective of this study was to review the efficacy, safety and types of CHM for depression. We systematically searched key databases (9 Chinese and 7 English) up until May 2013 for randomized controlled trials (RCTs) and examined 7 systematic reviews for additional articles. Methodological quality was assessed by modified Jadad scale and Cochrane's risk of bias assessment. Only studies with moderate methodological quality, defined as modified Jadad scale score ≥3, were included in meta-analysis for efficacy. Of the 296 RCTs that were assessed in details, 278 (93.9%) had modified Jadad scale score < 3, and only 21 scored ≥ 3. The frequently used formulas were Xiao Yao decoction, Chaihu Shugan decoction and Ganmai Dazao decoction; while Chaihu, Bai Shao and Fu Ling were the frequently used single herb. Meta-analyses showed that CHM monotherapy was better than placebo and as effective as antidepressants in reducing Hamilton Depression Rating Scale (HDRS) score (CHM vs. placebo: mean difference: -7.97, 95% CI: -10.25 to -5.70, P < 0.00001, 2 studies; CHM vs. antidepressants: mean difference: 0.01, 95% CI: -0.28 to 0.30, P = 0.95, 7 studies). CHM were associated with less adverse events than antidepressants, and adding CHM to antidepressants reduced adverse events. Despite the overall positive results, due to the small number of studies with sufficient methodological quality, it is premature to accurately conclude the benefits and risks of CHM for depression.
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Yeung WF, Chung KF, Ng KY, Yu YM, Ziea ETC, Ng BFL. A meta-analysis of the efficacy and safety of traditional Chinese medicine formula Ganmai Dazao decoction for depression. JOURNAL OF ETHNOPHARMACOLOGY 2014; 153:309-317. [PMID: 24632021 DOI: 10.1016/j.jep.2014.02.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ganmai Dazao (GMDZ) decoction is a traditional Chinese herbal formula commonly used for the treatment of depression. The objective of this study was to assess the efficacy and safety of GMDZ, either alone or as co-therapy, for depression. MATERIALS AND METHODS We systematically searched key databases (9 Chinese and 7 English) up until May 2013 for randomized controlled trials (RCTs). The primary outcomes were effective rate and self-rated or clinician-rated severity of depression. The secondary outcome was the occurrence of adverse events. Methodological quality of the RCTs was assessed by the Cochrane׳s risk of bias assessment. RESULTS Ten RCTs were included. All were written in Chinese and the methodological quality was generally low. Pooled analysis of 5 studies which compared GMDZ with antidepressants showed that GMDZ was significantly more efficacious than antidepressants in effective rate (risk ratio: 1.14, 95% CI: 1.02 to 1.27, P=0.02, I(2)=0%), but comparable in Hamilton Depression Rating Scale (HDRS) score (mean difference: -2.10, 95% CI: -4.62 to -0.41, P=0.10, I(2)=92%). With regard to the other 5 studies which compared GMDZ plus antidepressants with antidepressants alone, there was no significant difference in effective rate (risk ratio: 1.24, 95% CI: 0.99 to 1.55, P=0.07, I(2)=93%), but the end-point HDRS score was significantly lower in GMDZ antidepressants combination (mean difference: -4.25, 95% CI: -6.50 to -2.00, P=0.0002, I(2)=96%). Adverse events were more common with antidepressants than GMDZ (rate ratio: 0.52, 95% CI: 0.32 to 0.82, P=0.005, I(2)=37%) and in antidepressants alone compared to GMDZ antidepressants combination (rate ratio: 0.23, 95% CI: 0.08 to 0.68, P=0.08, I(2)=0%). CONCLUSION The overall results suggest that GMDZ has few side effects and the potential as an antidepressant. Adding GMDZ to antidepressants reduces side effects and enhances efficacy of antidepressants. However, due to the small number of studies and their limitations, further studies with better methodological quality and more comprehensive safety assessment are needed to determine the benefits and risks of GMDZ in the treatment of depression.
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Affiliation(s)
- Wing-Fai Yeung
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Ka-Fai Chung
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
| | - Ka-Yan Ng
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Yee-Man Yu
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Eric Tat-Chi Ziea
- The Chinese Medicine Department, Hospital Authority, Hong Kong SAR, China
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Chen MT, Li CY, Lin HC, Shen WW, Hsieh PC, Chen CC. Health-seeking behavior, alternative medicine, and quality of life in Taiwanese panic disorder patients. Int J Psychiatry Clin Pract 2013; 17:206-15. [PMID: 22809126 DOI: 10.3109/13651501.2012.713111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Panic disorder (PD) is an anxiety disorder characterized by spontaneous and unexpected panic attacks of varying frequency. Clinically manifest PD is widespread among the general population in developed countries worldwide. This study is aimed to identify factors influencing Taiwanese patients' decision to seek psychiatric help and to assess relationships between patients' health-seeking behaviors and quality of life (QOL). METHODS One hundred patients from the outpatient psychiatric clinic of a university hospital in Taiwan were evaluated for PD. RESULTS Delayed diagnosis of panic disorder, high comorbidity with other mental and physical disorders, and high utilization of health care services were identified. Thirty-three percent of PD patients sought alternative therapies, delaying their seeking psychiatric care. CONCLUSIONS More PD patients in Taiwan seek care from family practitioners and alternative and complementary medicine than from psychiatrists. Taiwanese patients with PD who seek psychiatric consultation more than one year after disease onset have lower QOL and lower physical health scores.
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Affiliation(s)
- Miao-Tzu Chen
- Department of Nursing, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
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Kuan YC, Yen DJ, Yiu CH, Lin YY, Kwan SY, Chen C, Chou CC, Yu HY. Treatment-seeking behavior of people with epilepsy in Taiwan: a preliminary study. Epilepsy Behav 2011; 22:308-12. [PMID: 21813332 DOI: 10.1016/j.yebeh.2011.06.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 06/26/2011] [Accepted: 06/28/2011] [Indexed: 10/17/2022]
Abstract
To understand the treatment-seeking behavior of people with epilepsy (PWE), 403 PWE were surveyed using structured face-to-face interviews. Nearly half (49.1%) of them had previously tried complementary and alternative medicine (CAM); traditional Chinese medicine (51.5%) and temple worship (48.0%) were the most frequently used forms of CAM. In the 155 patients with adult-onset epilepsy, seeking CAM was substantially more common among females (OR=2.11, 95% CI=1.05-4.24, P=0.036), patients with frequent seizures (OR=2.68, 95% CI=1.30-5.53, P=0.008), patients with less educated parents (OR=2.16, 95% CI=1.06-4.41, P=0.034), and patients with religious beliefs (OR=2.84, 95% CI=1.23-6.56, P=0.015). In the 248 patients with childhood-onset epilepsy, frequent seizures (OR=2.23, 95% CI=1.32-3.77, P=0.003) and lower level of parental education (OR=2.71, 95% CI=1.45-5.06, P=0.002) were significantly associated with CAM use. The patients who seek CAM before receiving conventional medical treatment decreased after implementation of the National Health Insurance (NHI) (34/188 before NHI vs 22/215 after NHI, P=0.023). This study showed that the prevalence of CAM use by PWE in Taiwan is high and that a convenient NHI program can affect treatment-seeking behavior.
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Affiliation(s)
- Yi-Chun Kuan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital and National Yan-Ming University, Taipei, Taiwan
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Solomon D, Ford E, Adams J, Graves N. Potential of St John's Wort for the treatment of depression: the economic perspective. Aust N Z J Psychiatry 2011; 45:123-30. [PMID: 20977305 DOI: 10.3109/00048674.2010.526094] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.
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Affiliation(s)
- Daniela Solomon
- School of Population Health, University of Queensland, Brisbane, Herston, Queensland, Australia.
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Use of Complementary and Alternative Medicine among People with Type 2 Diabetes in Taiwan: A Cross-Sectional Survey. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2010; 2011. [PMID: 20953402 PMCID: PMC2952338 DOI: 10.1155/2011/983792] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 05/19/2010] [Accepted: 07/10/2010] [Indexed: 11/17/2022]
Abstract
Research into CAM use by people with diabetes is limited. This study explored CAM use among patients who attend diabetic clinics for followup treatment. Special attention was paid to patients' changing patterns of CAM use before and after diagnosis with Type 2 diabetes, their experience of CAM use, and their management of CAM use with conventional medicines. A retrospective cross-sectional survey (n = 326) was undertaken in three census regions in Taiwan, including metropolitan, urban, and rural areas in 2006-7 (87.4% response rate). Participants reported extensive use of CAM with conventional medicines. The prevalence of CAM use was 22.7% before and 61.0% after diagnosis with Type 2 diabetes with nutritional supplements being the most commonly used CAM before and after diagnosis. However, the disclosure rate of CAM use to healthcare professionals remained low (24.6%), and lack of knowledge about CAM ingredients was common (63.4%). Awareness of the widespread use of CAM by people with Type 2 diabetes is crucial for healthcare professionals. The self-administration of both conventional medicines and CAM without disclosure of CAM use to healthcare professionals may result in ineffective diabetes management and adverse effects. CAM information needs to be incorporated into clinical practice and patient and professional education.
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