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Wu LK, Chen YC, Hung CS, Yen CY, Chang Chien CY, Ciou JR, Torng HH, Chang YC, Hua S, Lu PN, Liu YY, Lai CY, Kung YL, Huang HK, Chen ZK, Ho TJ. The efficacy and safety of cupping as complementary and alternative therapy for metabolic syndrome: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33341. [PMID: 37000047 PMCID: PMC10063281 DOI: 10.1097/md.0000000000033341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION This systematic review and meta-analysis aimed to assess the efficacy and safety of cupping therapy in patients with metabolic syndrome (MetS). METHODS This systematic review focused on patients with MetS and included randomized controlled trials (RCTs) that compared the effects of cupping therapy with control groups. A total of 12 electronic databases were searched from inception until February 03, 2023. The main outcome after the meta-analysis was waist circumference; the others included anthropometric variables, blood pressure, lipid profile, fasting blood glucose level, and high-sensitivity C-reactive protein level. The incidence of adverse events and the follow-up courses were also evaluated. Risk of bias (ROB) was evaluated using ROB 2.0 from the Cochrane Handbook. RESULTS This systematic review included five studies involving 489 patients. Some risks of bias were also identified. The meta-analysis revealed a statistically significance in waist circumference (MD = -6.07, 95% CI: -8.44 to -3.71, P < .001, I2 = 61%, τ2 = 3.4), body weight (MD = -2.46, 95% CI: -4.25 to -0.68, P = .007, I2 = 0%, τ2 = 0) and body mass index (MD = -1.26, 95% CI: -2.11 to -0.40, P = .004, I2 = 0%, τ2 = 0) between the cupping therapy and control groups. However, there were no significant results in total fat percentage and blood pressure values. Regarding biochemical markers, cupping significantly lowered the concentration of low-density lipoprotein cholesterol (MD = -3.98, 95% CI: -6.99 to -0.96, P = .010, I2 = 0%, τ2 = 0) but had no significant effect on total cholesterol, triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, and high-sensitivity C-reactive protein. 3 RCTs reported no adverse events. CONCLUSIONS Despite some ROB and low to substantial heterogeneity of the included studies, cupping therapy can be considered a safe and effective complementary intervention for reducing waist circumference, body weight, body mass index, and low-density lipoprotein cholesterol in patients with MetS. In the future, well-designed, high-quality, rigorous methodology, and long-term RCTs in this population are required to assess the efficacy and safety of cupping therapy.
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Affiliation(s)
- Li-Kung Wu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yi-Chen Chen
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Education and Human Potentials Development, National Dong Hwa University, Hualien, Taiwan
| | - Chung-Shan Hung
- Department of Aging and Community Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Chih-Yu Yen
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chen-Ying Chang Chien
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jian-Ruei Ciou
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Hsiao-Hsiang Torng
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yi-Chin Chang
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Shiuan Hua
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Peng-Nien Lu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yuan-Yuan Liu
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chun-Yu Lai
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yen-Lun Kung
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Huei-Kai Huang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Zhong-Kui Chen
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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El-Shanshory M, Hablas NM, Shebel Y, Alhadramy O, El-Tahlawi R, Aboonq MS, Soliman TM, Abdel-Gawad AR, El Sayed SM, Abdallah HI, Mahmoud HS, El-Allaf H, El-Sawy S, Yousef RS, Abu-el Naga M, Mariah RA, Nabo MMH, Abdel-Haleem M, Mahmoud AA, Hassan MA, Al Arabi AH, Alnakhli AA, El Sayed SM. Al-hijamah (the triple S treatment of prophetic medicine) exerts cardioprotective, tissue-protective and immune potentiating effects in thalassemic children: a pilot clinical trial. AMERICAN JOURNAL OF BLOOD RESEARCH 2020; 10:447-458. [PMID: 33489454 PMCID: PMC7811902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/24/2020] [Indexed: 06/12/2023]
Abstract
Thalassemia is a major health problem in affected children due to iron overload, increased oxidative stress, atherogenic lipid profile and tissue-damage. This study aims at investigating the cardioprotective and tissue-protective benefits of Al-hijamah and their impact on cell-mediated immunity for treating thalassemic children. This study aimed also at investigating the tissue-clearance principle of Taibah mechanism: whenever pathological substances are to be cleared from the human body, Al-hijamah is indicated. Al-hijamah was done to thalassemic children (15 males and 5 females having a mean age of 9.07 ± 4.26 years) using sterile disposable sets in a complete aseptic hospital environment. Prior ethical committee agreement (in addition to written patient's consents) was obtained from Tanta Faculty of Medicine, Egypt. Twenty thalassemic children received iron chelation therapy plus Al-hijamah for one session (30-60 minutes) versus an age and sex-matched thalassemic control group treated with iron chelation therapy only. Al-hijamah is a quite safe outpatient hematological procedure that significantly decreased serum cholesterol (from 129.75 ± 3.67 to 103.5 ± 4.18 mg/dl) and decreased serum triglycerides (from 109.25 ± 8.96 to 91.95 ± 7.22 mg/dl). Interestingly, Al-hijamah exerted significant tissue-protective effects (it decreased serum GPT from 98.65 ± 12.27 to 71.65 ± 32.78 U/L and serum GOT from 96.35 ± 14.33 to 69.35 ± 34.37 U/L). Al-hijamah-induced ferritin excretion caused decreased serum ferritin (high serum ferritin negatively correlated with cell mediated immunity). Al-hijamah exerted cardioprotective and tissue-protective and hypolipidemic effects. Al-hijamah decreased serum cholesterol and is cardioprotective for thalassemic patients as it protects against atherogenesis and atherosclerosis. Medical practice of Al-hijamah is strongly recommended in hospitals. Al-hijamah cleared blood significantly from causative pathological substances e.g. serum ferritin resulting in enhanced cell-mediated immunity (in agreement with the evidence-based Taibah mechanism).
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Affiliation(s)
- Mohamed El-Shanshory
- Prophetic Medicine Course and Research Group, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
- Department of Pediatrics, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | | | - Yasmin Shebel
- Department of Pediatrics, Tanta University Faculty of MedicineTanta, Gharbia, Egypt
| | - Osama Alhadramy
- Division of Cardiology, Department of Medicine, Taibah College of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Rehab El-Tahlawi
- Department of Microbiology, College of Medicine, Taibah UniversitySaudi Arabia
- Department of Microbiology, Faculty of Medicine, Zagazig UniversityEgypt
| | - Moutasem Salih Aboonq
- Department of Medical Physiology, Taibah College of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Tamer M Soliman
- Department of Clinical Pathology, Sohag Faculty of Medicine, Sohag UniversitySohag, Egypt
| | | | - Sayed Mostafa El Sayed
- Department of Anatomy, Faculty of Medicine, Ain Shams UniversityEgypt
- Department of Anatomy, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Hesham I Abdallah
- Department of Anatomy, Faculty of Medicine, Ain Shams UniversityEgypt
- Department of Anatomy, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Hany Salah Mahmoud
- Center of Scientific Foundation for Experimental Studies and ResearchIsmailia, Egypt
| | - Hassan El-Allaf
- Department of Medical Physiology, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Samer El-Sawy
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Reda S Yousef
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | - Mostafa Abu-el Naga
- Department of Anatomy, College of Medicine, Al-Rayyan National CollegesAl-Madinah, Saudi Arabia
- Department of Anatomy, Faculty of Medicine, New Damietta, Al-Azhar UniversityEgypt
| | - Reham A Mariah
- Department of Medical Biochemistry, Tanta Faculty of Medicine, Tanta UniversityTanta, Egypt
| | - Manal Mohamed Helmy Nabo
- Division of Pediatric Cardiology, Pediatrics Department, Maternity and Children HospitalHail, Saudi Arabia
- Division of Pediatric Cardiology, Pediatrics Department, Sohag Teaching Hospital, Ministry of HealthSohag, Egypt
| | - Mohamed Abdel-Haleem
- Department of Ear, Nose and Throat, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Ahmed Alamir Mahmoud
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
| | | | - Areej Hesham Al Arabi
- Department of Cardiology, Governorate of Health, Uhud HospitalAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Abdullah Ahmed Alnakhli
- Department of Cardiology, Governorate of Health, Uhud HospitalAl-Madinah Al-Munawwarah, Saudi Arabia
| | - Salah Mohamed El Sayed
- Prophetic Medicine Course and Research Group, Taibah College of MedicineAl-Madinah Al-Munawwarah, Saudi Arabia
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag UniversityEgypt
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah UniversityAl-Madinah Al-Munawwarah, Saudi Arabia
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Golmohammadi S, Tavasoli M, Asadi N. Prevalence and Risk Factors of Hyperuricemia in Patients with Chronic Kidney Disease and Non-Alcoholic Fatty Liver. Clin Exp Gastroenterol 2020; 13:299-304. [PMID: 32903892 PMCID: PMC7445503 DOI: 10.2147/ceg.s253619] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Background/Aims The number of patients with nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) is on the rise. Epidemiological studies have shown the role of hyperuricemia in the development of NAFLD and CKD through oxidative stress and inflammatory mediators. Therefore, this study was conducted to investigate the prevalence and risk factors of hyperuricemia in patients with CKD and NAFLD in Iran. Patients and Methods This study was conducted in 450 CKD patients. NAFLD was diagnosed by ultrasonography. According to the serum uric acid level, all CKD+ NAFLD+ patients were divided into non-hyperuricemia and hyperuricemia groups. The patients' demographic and clinical data such as age, sex, abdominal obesity, metabolic syndrome, diabetes, hypertension, CRP, hepatic steatosis, blood pressure, serum uric acid (UA), lipid and creatinine were collected for analysis. Results A total of 279 cases (62%) were diagnosed with NAFLD. The prevalence rate of NFALD in CKD patients was significantly lower in normal UA level than hyperuricemia (42.7% vs 57.3%) (P=0.039). The prevalence of hyperuricemia was about 57.3% in patients with CKD and NAFLD. Accordingly, 279 CKD patients with NAFLD were enrolled and divided into hyperuricemia (n =160) and non-hyperuricemia groups (n =119). Patients with hyperuricemia showed higher creatinine and lipid levels, and a lower GFR compared to patients with normal uric acid levels (P< 0.05). However, no significant difference was observed in age, sex, abdominal obesity, metabolic syndrome, hypertension, type 2 diabetes, CRP, and steatosis between hyperuricemia and non-hyperuricemia groups (P>0.05). Three factors, including type 2 diabetes, hyperlipidemia, and a low GFR, serve as independent risk factors for hyperuricemia (P<0.05). Conclusion The results showed a high prevalence of hyperuricemia in patients with CKD and NAFLD. A more comprehensive strategic management is necessary to address the potential harmful effects of hyperuricemia on the health of CKD+ NAFLD+ cases.
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Affiliation(s)
- Sima Golmohammadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Marjan Tavasoli
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nadia Asadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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