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Patsalis PC, Malik-Patsalis AB, Rauscher HG, Schaefers C, Useini D, Strauch JT, Zahn PK, Dobos GJ, Mügge A, Cramer H. Efficacy of Auricular Acupuncture and Lavender Oil Aromatherapy in Reducing Preinterventional Anxiety in Cardiovascular Patients: A Randomized Single-Blind Placebo-Controlled Trial. J Integr Complement Med 2022; 28:45-50. [PMID: 35085018 DOI: 10.1089/jicm.2021.0171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Auricular acupuncture at the "relaxation point" and lavender oil aromatherapy can reduce preoperative anxiety associated with increased mortality and morbidity. Data on the effect of combined auricular acupuncture and lavender oil aromatherapy in patients undergoing cardiovascular interventions with the use of local anesthesia or under conscious sedation are sparse. The authors sought to evaluate the efficacy of auricular acupuncture and lavender oil aromatherapy in reducing preinterventional anxiety in cardiovascular patients. Materials and Methods: Data of 80 consecutive patients undergoing diagnostic coronary angiography (n = 56) with or without percutaneous coronary intervention (n = 9) and right heart catheterization (n = 6), transcatheter aortic valve replacement (n = 17) and percutaneous mitral valve repair (MitraClip; n = 2) were analyzed. Patients were prospectively randomized to receive either preinterventional auricular acupuncture and lavender oil (Lavandula angustifolia) aromatherapy (verum group, n = 39) or combined sham auricular acupuncture and placebo oil aromatherapy (placebo group, n = 41). For the verum group bilateral auricular acupuncture was performed at the "relaxation point." State anxiety and blood pressure were assessed before and at 30 min after acupuncture and presternal oil application. State anxiety was defined as primary outcome measure and assessed using the Spielberger State Anxiety Inventory (STAI) for Adults form Y6. Intervention-specific anxiety was assessed by a 10-point numerical rating scale, and perceived treatment success by a single dichotomous question. Clinical blood pressure was further assessed. Results: After the intervention, the verum group had significantly decreased anxiety on the STAI compared with the placebo group (Δ = -4.18; 95% confidence interval = -8.31 to -0.05; p = 0.047). Significantly more patients reported subjective treatment success in the verum group (87.2%) than in the placebo group (65.9%, p = 0.035). No significant differences were observed regarding intervention-specific anxiety and blood pressure between the two groups. No serious adverse events occurred in any group. Conclusions: Combined auricular acupuncture and lavender oil aromatherapy can decrease preinterventional anxiety in cardiovascular patients and requires further investigation. German Clinical Trials Register (registration no. DRKS00023686).
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Affiliation(s)
- Polykarpos C Patsalis
- Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- Division of Cardiology and Emergency Medicine, Department of Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Amena B Malik-Patsalis
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Helen Gwendolin Rauscher
- Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Christian Schaefers
- Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Dritan Useini
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Justus Thomas Strauch
- Department of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Peter K Zahn
- Department of Anesthesiology, Intensive Care Medicine, Palliative Care Medicine and Pain Management, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Gustav J Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Andreas Mügge
- Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Dobos GJ, Böhler J, Kuhlmann J, Elsner J, Andre M, Passlick-Deetjen J, Schollmeyer PJ. Bicarbona Te-Based Dialysis Solution Preserves Granulocyte Functions. Perit Dial Int 2020. [DOI: 10.1177/089686089401400410] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Intraperitoneal phagocytes play an important role in local defense in preventing continuous ambulatory peritoneal dialysis (CAPD) peritonitis. This study therefore investigates the effect of the conventional lactate-based dialysis solution-pH 5.2 (LBDS-pH 5.2) and a bicarbonate-based dialysis solution (BBDS) on various cell functions. Design We studied C5a-induced actin polymerization (AP) as a measure of the cytoskeletal alteration, phagocytosis of zymosan particles, and chemotaxis in neutrophils incubated in either LBDS-pH 5.2, LBDS-pH 7.4, or BBDS-pH 7.4, comparing the data with cells treated with phosphate-buffered saline-pH 7.4 (PBS-pH 7.4) as a control. Subjects Polymorphonuclear neutrophils (PMNs) were isolated from the blood of healthy donors and incubated with dialysis solution prior to the experiment. Results C5a-induced AP was dramatically inhibited in PMNs incubated in LBDS-pH 5.2, paralleled by a complete inhibition of phagocytosis and C5a-induced chemotaxis. In comparison, BBDS improved AP to values above the control and also nearly normalized phagocytosis. Chemotaxis markedly improved in cells treated with the low glucose-containing BBDS (Bic 20), but was still inhibited in PMNs incubated in the BBDS containing high glucose concentrations (Bic 30). Conclusion In comparison with conventional lactate-based dialysis solution-pH 5.2, bicarbonate-based dialysis solution at low osmolality better preserves neutrophil functions that involve the cytoskeleton.
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Affiliation(s)
- Gustav J. Dobos
- Department of Nephrology, University Hospital Freiburg, Freiburg, and Fresenius AG,3 Oberursel, Germany
| | - Joachim Böhler
- Department of Nephrology, University Hospital Freiburg, Freiburg, and Fresenius AG,3 Oberursel, Germany
| | - Jens Kuhlmann
- Department of Nephrology, University Hospital Freiburg, Freiburg, and Fresenius AG,3 Oberursel, Germany
| | - Jörn Elsner
- Department of Dermatology, University Hospital Freiburg, Freiburg
| | - Martin Andre
- Department of Nephrology, University Hospital Freiburg, Freiburg, and Fresenius AG,3 Oberursel, Germany
| | | | - Peter J. Schollmeyer
- Department of Nephrology, University Hospital Freiburg, Freiburg, and Fresenius AG,3 Oberursel, Germany
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Brinkhaus B, Dobos GJ. The Crisis of Medicine and the Benefits of Complex Pain Therapy Procedures Such As Cupping: More Research Needed. Complement Med Res 2019; 26:145-147. [PMID: 31132767 DOI: 10.1159/000500466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Benno Brinkhaus
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Projektbereich Komplementäre und Integrative Medizin, Charité - Universitätsmedizin Berlin, Berlin, Germany,
| | - Gustav J Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deimelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deimelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deimelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34a, D-45276, Essen, Deutschland.
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Koch AK, Cramer H, Klose P, Dobos GJ, Langhorst J. Komplementäre Therapieverfahren in der aktualisierten AWMF-S3-Leitlinie «Diagnostik und Therapie der Colitis ulcerosa»: Der Stellenwert von Therapieansätzen aus dem komplementären Bereich nimmt weiter zu. Complement Med Res 2018; 25:289-291. [DOI: 10.1159/000494048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- Gustav J Dobos
- Kliniken Essen-Mitte, Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34a, D-45276, Essen, Deutschland.
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Affiliation(s)
- Gustav J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Am Deinelsberg 34 a, D-45276, Essen, Deutschland.
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Kumar S, Rampp T, Kessler C, Jeitler M, Dobos GJ, Lüdtke R, Meier L, Michalsen A. Effectiveness of Ayurvedic Massage (Sahacharadi Taila) in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med 2017; 23:109-115. [DOI: 10.1089/acm.2015.0272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Syal Kumar
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Thomas Rampp
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Gustav J. Dobos
- Department of Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Rainer Lüdtke
- Karl and Veronica Carstens Foundation, Essen, Germany
| | - Larissa Meier
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Centre and Immanuel Hospital Berlin, Berlin, Germany
- Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany
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Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev 2017; 1:CD010802. [PMID: 28045199 PMCID: PMC6465041 DOI: 10.1002/14651858.cd010802.pub2] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long-term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer-related impairments and has been shown to improve physical and mental health in people with different cancer types. OBJECTIVES To assess effects of yoga on health-related quality of life, mental health and cancer-related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment. SEARCH METHODS We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions. SELECTION CRITERIA Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non-metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient-reported instruments, including health-related quality of life, depression, anxiety, fatigue or sleep disturbances. DATA COLLECTION AND ANALYSIS Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random-effects model meta-analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention. MAIN RESULTS We included 24 studies with a total of 2166 participants, 23 of which provided data for meta-analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.Seventeen studies that compared yoga versus no therapy provided moderate-quality evidence showing that yoga improved health-related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD -0.48, 95% CI -0.75 to -0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD -0.25, 95% CI -0.40 to -0.09; six studies, 657 participants). The funnel plot for health-related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD -0.13, 95% CI -0.31 to 0.05; seven studies, 496 participants; low-quality evidence) or anxiety (pooled SMD -0.53, 95% CI -1.10 to 0.04; six studies, 346 participants; very low-quality evidence) in the short term and had no medium-term effects on health-related quality of life (pooled SMD 0.10, 95% CI -0.23 to 0.42; two studies, 146 participants; low-quality evidence) or fatigue (pooled SMD -0.04, 95% CI -0.36 to 0.29; two studies, 146 participants; low-quality evidence). Investigators reported no serious adverse events.Four studies that compared yoga versus psychosocial/educational interventions provided moderate-quality evidence indicating that yoga can reduce depression (pooled SMD -2.29, 95% CI -3.97 to -0.61; four studies, 226 participants), anxiety (pooled SMD -2.21, 95% CI -3.90 to -0.52; three studies, 195 participants) and fatigue (pooled SMD -0.90, 95% CI -1.31 to -0.50; two studies, 106 participants) in the short term. Very low-quality evidence showed no short-term effects on health-related quality of life (pooled SMD 0.81, 95% CI -0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD -0.21, 95% CI -0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety-related data.Three studies that compared yoga versus exercise presented very low-quality evidence showing no short-term effects on health-related quality of life (pooled SMD -0.04, 95% CI -0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD -0.21, 95% CI -0.66 to 0.25; three studies, 233 participants); no trial provided safety-related data. AUTHORS' CONCLUSIONS Moderate-quality evidence supports the recommendation of yoga as a supportive intervention for improving health-related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low-quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.
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Affiliation(s)
- Holger Cramer
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Romy Lauche
- University of Technology SydneyAustralian Research Centre in Complementary and Integrative Medicine235‐253 Jones StreetUltimoAustralia2007
| | - Petra Klose
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Silke Lange
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Jost Langhorst
- University of Duisburg‐EssenDepartment of Integrative Gastroenterology, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
| | - Gustav J Dobos
- University of Duisburg‐EssenDepartment of Internal and Integrative Medicine, Kliniken Essen‐Mitte, Faculty of MedicineAm Deimelsberg 34aEssenGermany45276
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Abstract
Traditional Indian medicine (ayurveda) is becoming increasingly popular, with many chronic conditions responding to it well. Most patients begin to take conventional medications as soon as their diagnoses are made, so ayurvedic treatments are usually undergone alongside and/or after conventional medical approaches. A detailed knowledge of the action of food, spices, and medicinal plants is needed in order to understand their potential influence fully. While societal use of ayurvedic plants and Indian spices is commonplace, without ill effect, the use of more concentrated products made from single plants, often in the form of teas or tablets, is of more concern. The mechanisms by which polyherbal drugs and their extracts act differ in many respects from the actions of single substances or synthetic drugs. Despite the fact that ayurvedic medicines are based on natural herbal materials, their safety depends on their method of administration, taking into account individuals’ needs and their specific disease conditions.
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Affiliation(s)
- Syal Kumar
- 1 University of Duisburg-Essen, Essen, Germany
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Koch AK, Klose P, Lauche R, Cramer H, Baasch J, Dobos GJ, Langhorst J. [A Systematic Review of Phytotherapy for Acute Rhinosinusitis]. Complement Med Res 2016; 23:165-9. [PMID: 27404100 DOI: 10.1159/000447467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Herbal medicine is a promising alternative in the treatment of acute rhinosinusitis (ARS). We performed a systematic review for phytopharmaceutical treatments of ARS. A computerized search of databases (Cochrane Library, PubMed, and Scopus) up to 16 September 2015 was performed. Randomized controlled trials (RCTs) and controlled trials (CTs) were included and assessed using the Cochrane risk of bias tool. Seven trials on Pelargonium sidoides (EPs 7630, Umckaloabo®), Myrtol (GeloMyrtol® forte), BNO 1016 (Sinupret® extract), BNO 101 (Sinupret®), Cyclamen europaeum (Nasodren®), and Esberitox® were included. Risk of bias was heterogeneous. EPs 7630 appeared to be useful in the treatment of ARS. Myrtol showed benefits against a placebo compound, and BNO 1016 and BNO 101 might be helpful; however, there was little evidence for the effectiveness of Cyclamen europaeum and Esberitox®. Herbal medicine might be effective for the treatment of ARS, but given the low number of clinical trials and the heterogeneous methodological quality, further research is necessary.
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Affiliation(s)
- Anna K Koch
- Centre of Integrative Gastroenterology, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Theysohn N, Choi KE, Gizewski ER, Wen M, Rampp T, Gasser T, Dobos GJ, Forsting M, Musial F. Acupuncture-related modulation of pain-associated brain networks during electrical pain stimulation: a functional magnetic resonance imaging study. J Altern Complement Med 2015; 20:893-900. [PMID: 25389905 DOI: 10.1089/acm.2014.0105] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Findings of existing functional MRI (fMRI) studies on the neural mechanisms that mediate effects of acupuncture analgesia are inconsistent. This study analyzes the effects of manual acupuncture on pain ratings and brain activation in response to experimental, electrical pain stimuli. DESIGN Fourteen healthy volunteers were examined by using a 1.5-T MRI scanner. The intensity of pain stimuli was adjusted to individual pain ratings on a numeric rating scale. Baseline fMRI was performed during electrical pain stimulation in a blocked design. For the second session, manual acupuncture with repeated stimulation was performed on contralateral acupoints-large intestine 4, liver 3, and stomach 36-before imaging. After imaging, subjective pain ratings and ratings of the de qi sensation were assessed. RESULTS Compared with baseline, volunteers showed modulated brain activity under pain conditions in the cingulate gyrus, insula, primary somatosensory cortex, and prefrontal areas after the acupuncture session. In accordance with the literature, anterior insular and prefrontal activity seemed to be correlated with acupuncture treatment. CONCLUSION This study supports the existence of analgesic acupuncture effects that outlast the needling period. Pain-associated brain areas were modulated in direct response to a preceding acupuncture treatment.
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Affiliation(s)
- Nina Theysohn
- 1 Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen , Essen, Germany
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Hack CC, Voiß P, Lange S, Paul AE, Conrad S, Dobos GJ, Beckmann MW, Kümmel S. Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine. Geburtshilfe Frauenheilkd 2015; 75:675-682. [PMID: 26257404 DOI: 10.1055/s-0035-1557748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 06/21/2015] [Accepted: 06/21/2015] [Indexed: 12/25/2022] Open
Abstract
With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patient's quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patients' wellbeing and quality of life, reducing stress, and improving patients' mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle.
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Affiliation(s)
- C C Hack
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - P Voiß
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen ; Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Lange
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - A E Paul
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Conrad
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - G J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - M W Beckmann
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - S Kümmel
- Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
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Langhorst J, Lauche R, Rasch M, Cramer H, Klose P, Dobos GJ. Systemic Review with meta-analysis on Complementary and Alternative Medicine Treatments in hepatitis. Integr Med Res 2015. [DOI: 10.1016/j.imr.2015.04.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Langhorst J, Wulfert H, Lauche R, Klose P, Cramer H, Dobos GJ, Korzenik J. Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases. J Crohns Colitis 2015; 9:86-106. [PMID: 25518050 DOI: 10.1093/ecco-jcc/jju007] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We performed a systematic review for Complementary and Alternative Medicine [CAM] as defined by the National Institute of Health in Inflammatory Bowel Disease [IBD], ie Crohn's disease [CD] and ulcerative colitis [UC], with the exception of dietary and nutritional supplements, and manipulative therapies. METHODS A computerized search of databases [Cochrane Library, Pubmed/Medline, PsychINFO, and Scopus] through March 2014 was performed. We screened the reference sections of original studies and systematic reviews in English language for CAM in IBD, CD and UC. Randomized controlled trials [RCT] and controlled trials [CT] were referred and assessed using the Cochrane risk of bias tool. RESULTS A total of: 26 RCT and 3 CT for herbal medicine, eg aloe-vera gel, andrographis paniculata, artemisia absinthium, barley foodstuff, boswellia serrata, cannabis, curcumin, evening primrose oil, Myrrhinil intest®, plantago ovata, silymarin, sophora, tormentil, wheatgrass-juice and wormwood; 1 RCT for trichuris suis ovata; 7 RCT for mind/body interventions such as lifestyle modification, hypnotherapy, relaxation training and mindfulness; and 2 RCT in acupuncture; were found. Risk of bias was quite heterogeneous. Best evidence was found for herbal therapy, ie plantago ovata and curcumin in UC maintenance therapy, wormwood in CD, mind/body therapy and self-intervention in UC, and acupuncture in UC and CD. CONCLUSIONS Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
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Affiliation(s)
- J Langhorst
- Department of Integrative Gastroenterology, Faculty of Medicine, University of Duisburg-Essen, Germany Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany
| | - H Wulfert
- Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany
| | - R Lauche
- Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany Australian Research Centre in Complementary and Integrative Medicine[], Faculty of Health, University of Technology Sydney, Australia
| | - P Klose
- Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany
| | - H Cramer
- Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany Australian Research Centre in Complementary and Integrative Medicine[], Faculty of Health, University of Technology Sydney, Australia
| | - G J Dobos
- Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Germany
| | - J Korzenik
- Department of Inflammatory Bowel Disease, Harvard Medical School, Boston, MA, USA
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Cramer H, Lauche R, Paul A, Langhorst J, Kümmel S, Dobos GJ. Hypnosis in breast cancer care: a systematic review of randomized controlled trials. Integr Cancer Ther 2014; 14:5-15. [PMID: 25233905 DOI: 10.1177/1534735414550035] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Many breast cancer patients and survivors experience pain and emotional stress related to their disease, its diagnostic procedures, or treatment. Hypnosis has long been used for the treatment of such symptoms. The aim of this review was to systematically assess the effectiveness of hypnosis in women with breast cancer, breast cancer survivors, and in women undergoing diagnostic breast biopsy. METHODS PubMed, Scopus, the Cochrane Library, PsycINFO, and CAMBASE were screened through February 2014 for randomized controlled trials (RCTs) of hypnosis in women with breast cancer or undergoing diagnostic breast biopsy. RCTs on postmenopausal women without a history of breast cancer were also eligible. Primary outcomes were pain, distress, fatigue, nausea/vomiting, and hot flashes. Safety was defined as secondary outcome measure. Risk of bias was assessed by 2 reviewers independently using the Cochrane Risk of Bias Tool. RESULTS Thirteen RCTs with 1357 patients were included. In women undergoing diagnostic breast biopsy (3 RCTs), hypnosis positively influenced pain and distress; 1 RCT on breast cancer surgery found effects of hypnosis on pain, distress, fatigue, and nausea. For women undergoing radiotherapy (3 RCTs), hypnosis combined with cognitive-behavioral therapy improved distress and fatigue. In 3 RCTs on women with and without a history of breast cancer experiencing hot flashes, hypnosis improved hot flashes and distress. Three RCTs on women with metastatic breast cancer found effects on pain and distress. CONCLUSIONS This systematic review found sparse but promising evidence for the effectiveness of hypnosis in breast cancer care. While more research is needed to underpin these results, hypnosis can be considered as an ancillary intervention in the management of breast cancer-related symptoms.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Anna Paul
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Sherko Kümmel
- Interdisclipinary Breast Cancer Center, Kliniken Essen-Mitte, Essen, Germany
| | - Gustav J Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Langhorst J, Frede A, Knott M, Pastille E, Buer J, Dobos GJ, Westendorf AM. Distinct kinetics in the frequency of peripheral CD4+ T cells in patients with ulcerative colitis experiencing a flare during treatment with mesalazine or with a herbal preparation of myrrh, chamomile, and coffee charcoal. PLoS One 2014; 9:e104257. [PMID: 25144293 PMCID: PMC4140685 DOI: 10.1371/journal.pone.0104257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 07/04/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We found the first evidence of the efficacy of a herbal treatment with myrrh, dry extract of chamomile flowers, and coffee charcoal for ulcerative colitis (UC). However, the impact of the herbal treatment on the CD4+ T-cell compartment, which is essential for both the induction of UC and the maintenance of tolerance in the gut, is not well understood. AIM To analyze the frequency and functional phenotype of CD4+ T cells and of immune-suppressive CD4+CD25high regulatory T cells (Tregs) in healthy control subjects, patients with UC in remission, and patients with clinical flare of UC. METHODS Patients in clinical remission were treated with either mesalazine or the herbal preparation for 12 months. The frequencies of whole CD4+ T cells, CD4+CD25med effector T cells, and Tregs and the expression of Foxp3 within the CD4+CD25hig Tregs were determined by flow cytometry at 6 time points. We determined the suppressive capability of Tregs from healthy control subjects and from patients in remission or clinical flare. RESULTS A total of 79 patients (42 women, 37 men; mean age, 48.5 years; 38 with clinical flare) and 5 healthy control subjects were included in the study. At baseline the frequencies of whole CD4+ T cells, CD4+CD25med effector cells, and Tregs did not differ between the two treatment groups and the healthy control subjects. In addition, patients with UC in sustained clinical remission showed no alteration from baseline after 1, 3, 6, 9, or 12 months of either treatment. In contrast, CD4+ T cells, CD4+CD25med effector T cells, and Tregs demonstrated distinctly different patterns at time points pre-flare and flare. The mesalazine group showed a continuous but not statistically significant increase from baseline to pre-flare and flare (p = ns). In the herbal treatment group, however, the percentage of the CD4+ T cells was lower at pre-flare than at baseline. This decrease was completely reversed after flare, when a significant increase was seen (CD4+CD25med pre-flare/flare p = 0.0461; CD4+CD25high baseline/flare p = 0.0269 and pre-flare/flare p = 0.0032). In contrast, no changes in the expression of Foxp3 cells were detected within the subsets of CD4+CD25high regulatory T cells. Of note, no alterations were detected in the suppressive capability of CD4+CD25high regulatory T cells isolated from the peripheral blood of healthy donors, from patients in remission, or from patients with clinical flare. CONCLUSIONS In patients with UC experiencing acute flare, the CD4+ T compartment demonstrates a distinctly different pattern during treatment with myrrh, chamomile extract, and coffee charcoal than during treatment with mesalazine. These findings suggest an active repopulation of regulatory T cells during active disease. TRIAL REGISTRATION EU Clinical Trials Register 2007-007928-18/DE.
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Affiliation(s)
- Jost Langhorst
- Department for Integrative Gastroenterology, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
- Department for Internal and Integrative Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Annika Frede
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Knott
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Eva Pastille
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gustav J. Dobos
- Department for Internal and Integrative Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Astrid M. Westendorf
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Lauche R, Cramer H, Langhorst J, Michalsen A, Dobos GJ. Reliability and validity of the pain on movement questionnaire (POM) in chronic neck pain. Pain Med 2014; 15:1850-6. [PMID: 25138685 DOI: 10.1111/pme.12534] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This analysis aimed to determine reliability, validity, and responsiveness of the pain on movement (POM) questionnaire, an instrument developed to determine pain intensity induced by head movement. DESIGN Data from nine randomized controlled trials for the treatment of chronic nonspecific neck pain were reanalyzed to determine reliability and validity of the POM questionnaire. METHODS POM was assessed as ratings of pain intensity induced by head movement in six different directions. The instrument's structure was assessed using a factor analysis. Reliability (internal consistency) was determined using Cronbach's alpha, and validity (convergent validity) was determined by correlating the POM with pain at rest on a visual analog scale (VAS), the neck disability index (NDI), quality of life (short-form 36 health survey questionnaire [SF-36]) and range of motion. Responsiveness was indicated by sensitivity to changes over time in a subsample of 49 patients. RESULTS Overall, 482 patients (mean age 50.3 ± 12.4 years, 72.3% female) were included in the analysis, and 458 of them provided complete data set for the POM. Average POM was 43.9 ± 20.8 mm on the VAS. The POM showed very good reliability as indicated by high internal consistency and moderate validity as indicated by significant correlations with the pain at rest, the NDI, and the SF-36. No correlations were found for POM with range of motion. The POM further proved to be responsive as it was sensitive to changes over time, and those changes were correlated to changes in pain intensity and NDI. CONCLUSIONS The POM seems to be a reliable and valid instrument to assess POM in patients with chronic nonspecific neck pain.
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Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Lauche R, Cramer H, Klose P, Kraft K, Dobos GJ, Langhorst J. Herbal medicines for the treatment of inflammatory bowel disease. Hippokratia 2014. [DOI: 10.1002/14651858.cd011223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Romy Lauche
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Holger Cramer
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Petra Klose
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Karin Kraft
- Universitätsmedizin Rostock; Center of Internal Medicine; Rostock Germany
| | - Gustav J Dobos
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
| | - Jost Langhorst
- University of Duisburg-Essen; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany
- University of Duisburg-Essen; Department for Integrative Gastroenterology, Kliniken Essen-Mitte, Faculty of Medicine; Am Deimelsberg 34a Essen Germany 45276
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Haller H, Lauche R, Cramer H, Rampp T, Saha FJ, Ostermann T, Dobos GJ. Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Follow-up Study. J Altern Complement Med 2014. [DOI: 10.1089/acm.2014.5043.abstract] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Heidemarie Haller
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Romy Lauche
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Holger Cramer
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Thomas Rampp
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Felix J. Saha
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Thomas Ostermann
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Gustav J. Dobos
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
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Haller H, Ostermann T, Lauche R, Cramer H, Dobos GJ. Controlling for Placebo Effects in Clinical Trials of Craniosacral Therapy: Blinding Success and Credibility of a New Sham-Control Protocol. J Altern Complement Med 2014. [DOI: 10.1089/acm.2014.5349.abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Heidemarie Haller
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Thomas Ostermann
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Romy Lauche
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Holger Cramer
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
| | - Gustav J. Dobos
- (1) Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany
- (2) Institute for Integrative Medicine, Department of Health, Witten/Herdecke University, Herdecke, Germany
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Cramer H, Lauche R, Langhorst J, Dobos GJ, Michalsen A. Validation of the German version of the Neck Disability Index (NDI). BMC Musculoskelet Disord 2014; 15:91. [PMID: 24642209 PMCID: PMC3999938 DOI: 10.1186/1471-2474-15-91] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 03/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Neck Disability Index (NDI) is the most commonly used outcome measure for neck pain. This study aimed to determine the psychometric properties of a German version of the NDI. Cross-cultural translation and psychometric testing of the NDI were performed. METHODS The 10-item NDI was translated into German and administered to 558 patients with chronic unspecific neck pain (Mean age 49.9 ± 11.4 years, 76% female). The factor structure and reliability of the NDI were assessed using factor analysis, Cronbach's alpha, split-half reliability (Spearman-Brown coefficient), and intra-class correlation (ICC2,1). To determine convergent validity, pain intensity (visual analog scale; VAS), pain on movement (VAS), and quality of life (Short Form 36 Health Survey Questionnaire; SF-36) were correlated with the NDI. Correlation with range of motion and sensitivity to change were also assessed in a subsample of 49 patients. RESULTS The mean NDI score was 32.75 ± 13.09. Factor analysis revealed a single factor that explained 39.8% of the variance. Cronbach's alpha was 0.81; Spearman-Brown coefficient was 0.80; and intra-class correlation was 0.81 (95% confidence interval = 0.78, 0.83). Significant correlations were found for pain intensity (r = 0.22, p < 0.01), pain on movement (r = 0.39, p < 0.01), quality of life (r = -0.30 to -0.45, p < 0.01), and range of motion (r = -0.34, p = 0.02). Patients who reported global improvement of health after an exercise or yoga intervention showed a higher decrease on the NDI than patients who reported no global improvement (p < 0.01). CONCLUSIONS The German version of the NDI has a comparable factor structure as the original version, acceptable psychometric properties, and is sensitive to change after physical activity. Neck disability is associated with other measures of neck pain.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany.
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Spahn G, Choi KE, Kennemann C, Lüdtke R, Franken U, Langhorst J, Paul A, Dobos GJ. Can a multimodal mind-body program enhance the treatment effects of physical activity in breast cancer survivors with chronic tumor-associated fatigue? A randomized controlled trial. Integr Cancer Ther 2014; 12:291-300. [PMID: 23766391 DOI: 10.1177/1534735413492727] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Background. Chronic fatigue is one of the most restricting symptoms following primary breast cancer treatment, but clinical studies on symptom management are rare. The objective was to evaluate the impact of a multimodal mind-body program (MMMT), including moderate physical activity as compared with a walking intervention alone, on chronic fatigue symptoms of women with stage I to IIIA breast cancer. PATIENTS AND METHODS Sixty-four women (mean age = 56.7 years) suffering from chronic fatigue after active tumor treatment were randomly assigned to either an experimental or a control (n = 32 each) intervention (10 weeks). Fatigue, quality of life (QoL), functional well-being, anxiety, and depression were measured with standard questionnaires at baseline, after 10 weeks, and after 3 months. RESULTS Compared with baseline, both groups had reduced fatigue scores after treatment without any significant difference between groups (posttreatment, Δ = -0.3, confidence interval = -1.6 to 1.0, P = .678; follow-up, Δ = -0.4, confidence interval = -1.8 to 0.9, P = .510). All patients also improved regarding QoL and general functional well-being. CONCLUSION Since both interventions reduced fatigue symptoms and enhanced QoL to a similar extent, we observed no verifiable add-on effect of the MMMT regarding fatigue symptoms. Considering the higher costs with additional expenditure related to MMMT, home-based walking intervention is recommended.
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Affiliation(s)
- Günther Spahn
- Clinic Öschelbronn CIMK, Center for Integrative Medicine and Cancer treatment, Niefern-Öschelbronn, Germany
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Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for women diagnosed with breast cancer. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Michalsen A, Kuhlmann MK, Lüdtke R, Bäcker M, Langhorst J, Dobos GJ. Prolonged fasting in patients with chronic pain syndromes leads to late mood-enhancement not related to weight loss and fasting-induced leptin depletion. Nutr Neurosci 2013; 9:195-200. [PMID: 17263085 DOI: 10.1080/10284150600929656] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Periods of fasting are practiced worldwide on a cultural/religious background, and related mood-enhancing effects are postulated. We aimed to assess the effect of fasting on mood and to explore the interaction with neuroendocrine activation and leptin depletion in a controlled explorative study on consecutive inpatients (BMI < 35 kg/m2) of a nutritional ward. 36 subjects (38.9 +/- 7.0 years; 29 female, BMI 26.7 +/- 4.1 kg/m2) participated in an 8-day modified fast (300 kcal/day), 19 patients (38.1 +/- 5.9 years; 18 female, 23.5 +/- 4.1 kg/m2) received a mild low calorie diet. Measurements included daily ratings of mood (VAS), weight and levels of leptin and cortisol at four time-points of the 2-week study period. Weight loss was 4.8 +/- 1.2 and 1.6 +/- 0.9 kg in fasters and controls, respectively. Fasters showed a more pronounced decrease of leptin (58% vs. 20%; P < 0.001) and a 17% increase of cortisol levels (P < 0.001). Mood ratings increased significantly in the late phase of fasting (P < 0.01) but were not related to weight-loss, leptin-depletion or cortisol increase. Our findings suggest that fasting induces specific mood-enhancement. The physiological mediator appears to be neither leptin nor cortisol, the role of other mechanisms has to be further studied.
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Affiliation(s)
- Andreas Michalsen
- Department of Internal Medicine V, University Duisburg-Essen, Kliniken Essen-Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany.
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Langhorst J, Varnhagen I, Schneider SB, Albrecht U, Rueffer A, Stange R, Michalsen A, Dobos GJ. Randomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis--a double-blind, double-dummy study. Aliment Pharmacol Ther 2013; 38:490-500. [PMID: 23826890 DOI: 10.1111/apt.12397] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 04/15/2013] [Accepted: 06/14/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND The herbal treatment with myrrh, dry extract of chamomile flowers and coffee charcoal has anti-inflammatory and antidiarrhoeal potential and might benefit patients with UC. Aminosalicylates are used as standard treatment for maintaining remission in ulcerative colitis (UC). AIM To compare the efficacy of the two treatments in maintaining remission in patients with ulcerative colitis. METHODS We performed a randomised, double-blind, double-dummy study over a 12-month period in patients with UC. Primary endpoint was non-inferiority of the herbal preparation as defined by mean Clinical Colitis Activity Index (CAI-Rachmilewitz). Secondary endpoints were relapse rates, safety profile, relapse-free times, endoscopic activity and faecal biomarkers. RESULTS A total of 96 patients (51 female) with inactive UC were included. Mean CAI demonstrated no significant difference between the two treatment groups in the intention-to-treat (P = 0.121) or per-protocol (P = 0.251) analysis. Relapse rates in total were 22/49 patients (45%) in the mesalazine treatment group and 25/47 patients (53%) in the herbal treatment group (P = 0.540). Safety profile and tolerability were good and no significant differences were shown in relapse-free time, endoscopy and faecal biomarkers. CONCLUSIONS The herbal preparation of myrrh, chamomile extract and coffee charcoal is well tolerated and shows a good safety profile. We found first evidence for a potential efficacy non-inferior to the gold standard therapy mesalazine, which merits further study of its clinical usefulness in maintenance therapy of patients with ulcerative colitis. EudraCT-Number 2007-007928-18.
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Affiliation(s)
- J Langhorst
- Department for Integrative Gastroenterology, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany.
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Lauche R, Langhorst J, Dobos GJ, Cramer H. Clinically meaningful differences in pain, disability and quality of life for chronic nonspecific neck pain – A reanalysis of 4 randomized controlled trials of cupping therapy. Complement Ther Med 2013; 21:342-7. [DOI: 10.1016/j.ctim.2013.04.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/17/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022] Open
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Abstract
Ayurveda is from a global viewpoint the oldest and the most employed traditional form of medicine in India. The difference to western medicine is that this form of medicine is based on experience, empirical evidence and intuition accumulated over thousands of years and passed down through generations orally as well as by sketches. Ayurveda is not only concerned with the physical but also with the spiritual aspects of the body and according to this doctrine most diseases result from psychological and pathological alterations in the body. Ultimately, the definition of health according to Ayurveda is an equilibrium between the physical, mental and spiritual components. Ayurvedic medicine is used within the framework of the treatment of urolithiasis for diuresis, for litholysis, as an analgetic for spasms and with an antimicrobial function.
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Affiliation(s)
- J Mani
- Klinik für Urologie und Kinderurologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt a.M., Deutschland.
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Paul A, Cramer H, Lauche R, Altner N, Langhorst J, Dobos GJ. An oncology mind-body medicine day care clinic: concept and case presentation. Integr Cancer Ther 2013; 12:503-7. [PMID: 23329568 DOI: 10.1177/1534735412473639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Cancer diagnosis and treatment are often associated with physical and psychosocial impairments. Many cancer patients request complementary and alternative therapies such as mind-body medicine. CONCEPT The department of internal and integrative medicine at the Essen-Mitte Clinics offer a mind-body medicine day care clinic for cancer patients that is based on the Mindfulness-Based Stress Reduction Program and the mind-body medicine cancer program of the Harvard Mind/Body Medical Institute. The program encompasses mindfulness training, yoga, mindful exercise, nutrition, naturopathic self-help strategies, and cognitive restructuring. CASES Two patients who had participated in the day care clinic program are presented here. One patient presented with anxiety and depression after recently diagnosed breast cancer and the other with psychological impairments as a result of multiple nevi excision after malignant melanoma surgery. Both patients improved in terms of anxiety and further psychological symptoms. CONCLUSIONS The Essen-Mitte Clinics mind-body medicine day care clinic appears to alleviate psychological consequences of cancer and its treatment. Further studies and randomized controlled trials are necessary to confirm these results.
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Affiliation(s)
- Anna Paul
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Paul AE, Lange S, Voiß P, Klose P, Kümmel S, Dobos GJ. Das «Essener Modell» - ein Konzept zur integrativ-onkologischen Therapie von Brustkrebspatientinnen. Breast Care (Basel) 2013. [DOI: 10.1159/000354728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Dobos GJ, Voiss P, Schwidde I, Choi KE, Paul A, Kirschbaum B, Saha FJ, Kuemmel S. Integrative oncology for breast cancer patients: introduction of an expert-based model. BMC Cancer 2012; 12:539. [PMID: 23170989 PMCID: PMC3582454 DOI: 10.1186/1471-2407-12-539] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/16/2012] [Indexed: 11/15/2022] Open
Abstract
Background Malignant breast neoplasms are among the most frequent forms of cancer in the Western world. Conventional treatment of breast cancer may include surgery, hormonal therapy, chemotherapy, radiation and/or immunotherapy, all of which are often accompanied by severe side effects. Complementary and alternative medicine (CAM) treatments have been shown to be effective in alleviating those symptoms. Furthermore, with patient survival rates increasing, oncologists, psychologists and other therapists have to become more sensitive to the needs of cancer survivors that go beyond than the mere alleviation of symptoms. Many CAM methods are geared to treat the patient in a holistic manner and thus are also concerned with the patient’s psychological and spiritual needs. Discussion The use of certain CAM methods may become problematic when, as frequently occurs, patients use them indiscriminately and without informing their oncologists. Herbal medicines and dietary supplements, especially, may interfere with primary cancer treatments or have other detrimental effects. Thus, expertise in this highly specialized field of integrative medicine should be available to patients so that they can be advised about the benefits and negative effects of such preparations and practices. Being a beneficial combination of conventional and CAM care, integrative oncology makes possible the holistic approach to cancer care. The concept of integrative oncology for breast cancer is jointly practiced by the Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, academic teaching hospital of the University of Duisburg-Essen, and the Breast Center at Kliniken Essen-Mitte in Germany. This model is introduced here; its scope is reviewed, and its possible implications for the practice of integrative medicine are discussed. Summary Evidence-based integrative care is crucial to the field of oncology in establishing state-of-the-art care for breast cancer patients.
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Affiliation(s)
- Gustav J Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, academic teaching hospital of the University of Duisburg-Essen, Am Deimelsberg 34 a, 45276 Essen, Germany.
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Abstract
Traditional Indian medicine-ayurveda-could be the oldest medical system in which leech therapy was adopted for treating specific disease conditions of patients. Some of the indications in which leeches are used are in tumors, hemorrhoids, abscess and boils, skin disorders, ulcers, gout, diseases of the eye, headache, herpes zoster, thrombosis, and wounds. The saliva of the leech consists of anesthetic agents, anticoagulant, antiplatelet aggregation factor, antibiotic, anti-inflammatory substances, and gelatinous substances. Leeches suck the excess blood, reduce the swelling in the tissues, and promote healing by allowing fresh oxygenated blood to reach the area until normal circulation can be restored. Clinical studies have been conducted in different parts of the world to observe the scientific action of leech therapy. Studies with leeches have been carried out to observe the healing of complicated varicose veins, pain reduction in osteoarthritis, and other disorders.
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Affiliation(s)
- Syal Kumar
- 1 University of Duisburg-Essen, Essen, Germany
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Houschyar KS, Lüdtke R, Dobos GJ, Kalus U, Broecker-Preuss M, Rampp T, Brinkhaus B, Michalsen A. Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome: results from a randomized clinical trial. BMC Med 2012; 10:54. [PMID: 22647517 PMCID: PMC3386865 DOI: 10.1186/1741-7015-10-54] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 05/30/2012] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metabolic syndrome (METS) is an increasingly prevalent but poorly understood clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity. Increased oxidative stress catalyzed by accumulation of iron in excess of physiologic requirements has been implicated in the pathogenesis of METS, but the relationships between cause and effect remain uncertain. We tested the hypothesis that phlebotomy-induced reduction of body iron stores would alter the clinical presentation of METS, using a randomized trial. METHODS In a randomized, controlled, single-blind clinical trial, 64 patients with METS were randomly assigned to iron reduction by phlebotomy (n = 33) or to a control group (n = 31), which was offered phlebotomy at the end of the study (waiting-list design). The iron-reduction patients had 300 ml of blood removed at entry and between 250 and 500 ml removed after 4 weeks, depending on ferritin levels at study entry. Primary outcomes were change in systolic blood pressure (SBP) and insulin sensitivity as measured by Homeostatic Model Assessment (HOMA) index after 6 weeks. Secondary outcomes included HbA1c, plasma glucose, blood lipids, and heart rate (HR). RESULTS SBP decreased from 148.5 ± 12.3 mmHg to 130.5 ± 11.8 mmHg in the phlebotomy group, and from 144.7 ± 14.4 mmHg to 143.8 ± 11.9 mmHg in the control group (difference -16.6 mmHg; 95% CI -20.7 to -12.5; P < 0.001). No significant effect on HOMA index was seen. With regard to secondary outcomes, blood glucose, HbA1c, low-density lipoprotein/high-density lipoprotein ratio, and HR were significantly decreased by phlebotomy. Changes in BP and HOMA index correlated with ferritin reduction. CONCLUSIONS In patients with METS, phlebotomy, with consecutive reduction of body iron stores, lowered BP and resulted in improvements in markers of cardiovascular risk and glycemic control. Blood donation may have beneficial effects for blood donors with METS. TRIAL REGISTRATION ClinicalTrials.gov: NCT01328210 Please see related article: http://www.biomedcentral.com/1741-7015/10/53.
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Affiliation(s)
- Khosrow S Houschyar
- Department of Internal Medicine, Kliniken Essen-Mitte, University Duisburg-Essen, Essen, Germany
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Lauche R, Wübbeling K, Lüdtke R, Cramer H, Choi KE, Rampp T, Michalsen A, Langhorst J, Dobos GJ. Randomized Controlled Pilot Study: Pain Intensity and Pressure Pain Thresholds in Patients with Neck and Low Back Pain Before and After Traditional East Asian "Gua Sha" Therapy. Am J Chin Med 2012; 40:905-917. [DOI: 10.1142/s0192415x1250067x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Gua Sha is a traditional East Asian healing technique where the body surface is "press-stroked" with a smooth-edged instrument to raise therapeutic petechiae that last 2–5 days. The technique is traditionally used in the treatment of both acute and chronic neck and back pain. This study aimed to measure the effects of Gua Sha therapy on the pain ratings and pressure pain thresholds of patients with chronic neck pain (CNP) and chronic low back pain (CLBP). A total of 40 patients with either CNP or CLBP (mean age 49.23 ± 10.96 years) were randomized to either a treatment group (TG) or a waiting list control group (WLC). At baseline assessment (T1), all patients rated their pain on a 10 cm visual analog scale (VAS). Patients' pressure pain thresholds (PPT) at a site of maximal pain (pain-maximum) and an adjacent (pain-adjacent) site were also established. The treatment group then received a single Gua Sha treatment. Post-intervention measurements were taken for both groups at T2, seven days after baseline assessment (T1), using the same VAS and PPT measurements in precisely the same locations as at T1. Final analysis were conducted with 21 patients with CNP and 18 patients with CLBP. The study groups were equally distributed with regard to randomization. Patients in both the CNP and the CLBP treatment groups reported pain reduction (p < 0.05) and improved health status from their one Gua Sha treatment, as compared to the waiting list group. Pain sensitivity improved in the TG in CNP, but not in CLBP patients, possibly due to higher pressure sensitivity in the neck area. No adverse events were reported. These results suggest that Gua Sha may be an effective treatment for patients with chronic neck and low back pain. Further study of Gua Sha is warranted.
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Affiliation(s)
- Romy Lauche
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Klaus Wübbeling
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Rainer Lüdtke
- Karl and Veronica Carstens Foundation, Essen, Germany
| | - Holger Cramer
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Kyung-Eun Choi
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Thomas Rampp
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Andreas Michalsen
- Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany
| | - Jost Langhorst
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav J. Dobos
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
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Lauche R, Cramer H, Haller H, Musial F, Langhorst J, Dobos GJ, Berger B. My Back Has Shrunk: The Influence of Traditional Cupping on Body Image in Patients with Chronic Non-Specific Neck Pain. Forsch Komplementmed 2012; 19:68-74. [DOI: 10.1159/000337688] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Lehmann N, Paul A, Moebus S, Budde T, Dobos GJ, Michalsen A. Effects of lifestyle modification on coronary artery calcium progression and prognostic factors in coronary patients--3-year results of the randomized SAFE-LIFE trial. Atherosclerosis 2011; 219:630-6. [PMID: 21944697 DOI: 10.1016/j.atherosclerosis.2011.08.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 07/21/2011] [Accepted: 08/30/2011] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Given the multimodal medical and interventional treatment options in coronary artery disease (CAD), the current value of intensified lifestyle modification remains unclear. No randomized studies have so far assessed the impact of lifestyle modification on coronary artery calcium (CAC). We examined the long-term effects of a one-year comprehensive lifestyle modification on risk factors and CAC by means of a randomized clinical trial. METHODS 96 participants (age range 35-75 years, 22 women) of the SAFE-LIFE randomized trial in patients with established CAD completed 3-year follow-up. The active treatment was a one-year lifestyle modification and stress reduction intervention (LG), while the control group received written advice only (AG). CAC (derived from electron beam tomography), blood lipids, heart rate, blood pressure, anginal symptoms and quality-of-life were assessed on entry and at 3-year follow-up. RESULTS Lifestyle modification had no impact on change of CAC after three years (median progression factor [25th,75th percentile] 1.46 [1.16,2.19] in LG and 1.41 [1.20,1.79] in AG; p=0.68), but led to reductions of blood pressure, heart rate and to dose-reductions in anti-ischemic medications as compared to AG. Multiple regression analysis indicated that in the pooled study population increase of CAC was related to psychosocial factors and heart rate. CONCLUSION In the presence of modern treatments, complementary prescription of comprehensive lifestyle modification has no impact on CAC progression but sustainable benefit for blood pressure, heart rate and the need of anti-ischemic medication is demonstrated. A possible influence of stress reduction measures on CAC progression should be further evaluated.
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Affiliation(s)
- Nils Lehmann
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany
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Lauche R, Cramer H, Choi KE, Rampp T, Saha FJ, Dobos GJ, Musial F. The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain--a randomised controlled pilot study. Altern Ther Health Med 2011; 11:63. [PMID: 21843336 PMCID: PMC3224248 DOI: 10.1186/1472-6882-11-63] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 08/15/2011] [Indexed: 11/17/2022]
Abstract
Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Results Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. Conclusions A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. Trial registration The trial was registered at clinicaltrials.gov (NCT01289964).
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Wilson E, Rajamanickam GV, Dubey GP, Klose P, Musial F, Saha FJ, Rampp T, Michalsen A, Dobos GJ. Review on shilajit used in traditional Indian medicine. J Ethnopharmacol 2011; 136:1-9. [PMID: 21530631 DOI: 10.1016/j.jep.2011.04.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 04/11/2011] [Accepted: 04/12/2011] [Indexed: 05/30/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Shilajit is a multi-component natural occurring mineral substance used in Ayurveda and Siddha systems of medicine which originated in India. Its source can be traced to the mountainous regions, where the hilly tribes first identified its beneficial use. Shilajit is aptly referred to as 'rasayana'/'rasayanam' in Ayurveda and Siddha literature which means rejuvenator because it prevents ailment and enhances the quality of life. MATERIALS AND METHODS An attempt has been put forth to review shilajit pertaining to its origin, synonyms, varieties, physical properties, chemical constituents, therapeutic properties and important biological properties to affirm its rasayana property. All relevant information on shilajit was collected from classical texts including pharmacopoeias, formularies, etc. Moreover, select doctoral thesis from Banaras Hindu University, Varanasi and Gujarat Ayurved University, Jamnagar were also scanned. Published papers on shilajit were collected from important databases for biomedical sciences. Amongst, the various biological properties of shilajit, antioxidant activity and immuno-modulatory activity were focused as it is closely related to its rasayana potential. RESULTS This review finds that shilajit is used in twenty Sastric formulations and twenty-four proprietary drugs for extraneous indications. Even-though, there is a long history of use of shilajit in traditional Indian materia medica, shilajit unfortunately lacks scientific evaluation and systematic documentation. In vivo antioxidant activity of shilajit has been studied at an irrelevant dose and without using a positive control. The immuno-modulatory activity does not stand the test of critical assessment and currently may be considered as unproven. CONCLUSION Based on the earlier studies, the bioactivity of shilajit lacks substantial evidence. Nevertheless, further studies are imperative to overcome the lacuna in establishing the antioxidant property of shilajit and more specific assays are needed to vouch shilajit as an immuno-modulator which may be of use to establish its rasayana potential.
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Affiliation(s)
- Eugene Wilson
- Department of Complementary & Integrative Medicine, Kliniken Essen Mitte, Knappschafts-Krankenhaus, Am Deimelsberg 34 a, 45276 Essen, Germany.
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Abendroth A, Michalsen A, Lüdtke R, Rüffer A, Musial F, Dobos GJ, Langhorst J. Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet. ACTA ACUST UNITED AC 2010; 17:307-13. [PMID: 21196744 DOI: 10.1159/000322313] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND therapeutic dietary interventions are effective treatments for rheumatoid arthritis (RA). The mechanisms to affect inflammation and clinical outcome in rheumatoid arthritis are only partly understood. Alterations in intestinal microflora are believed to be associated with disease activity in RA. AIM to evaluate changes in short-chain fatty acid (SCFA) profiles and clinical outcome in RA during medical fasting or mediterranean diet. METHODS Fifty consecutive in-patients from an Integrative Medicine Department were included in a prospective observational, non-randomised, clinical trial. Patients underwent a 7-day fasting (MF) therapy or a Mediterranean diet (MD) as part of a multimodal therapeutic treatment approach. RESULTS the mean Disease Activity Score (DAS-28) significantly decreased in both groups (p < 0.001) from 5.7 ± 0.9 to 4.1 ± 1.3 in the MF and from 5.4 ± 1.4 to 4.5 ± 1.3 in the MG group, with no significant difference between the groups (p = 0.115). VAS showed a consecutive decrease of pain in both study groups which was significantly higher in the fasting group on day 7 (p = 0.049). No significant differences between the study groups were found in the profile of total-fatty acids (p = 0.069), butyrate (p = 0.611) and propionate (p = 0.419). Measurement of acetate, however, showed significant differences (p = 0.044) with an increase from 17,4 ± 9.8 μmol/g to 21,4 ± 16.4 μmol/g in MF compared to a decrease from 15,2 ± 10.4 μmol/g to 13,8 ± 9.3 μmol/g in MD. There was no significant correlation between dietary induced changes of SCFA and changes of disease activity. CONCLUSION alterations in SCFA were found in terms of significant changes to increased acetate levels in the fasting group. A correlation between changes of SCFA from intestinal microflora and disease activity in RA could not be revealed. Further studies are needed in the field of dietary inducible changes of the intestinal microflora in patients with RA.
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Affiliation(s)
- Annalena Abendroth
- Kliniken Essen-Mitte, Knappschaftskrankenhaus, Department for Internal Medicine V: Naturopathy and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
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Choi KE, Musial F, Amthor N, Rampp T, Saha FJ, Michalsen A, Dobos GJ. Isolated and combined effects of electroacupuncture and meditation in reducing experimentally induced ischemic pain: a pilot study. Evid Based Complement Alternat Med 2010; 2011:950795. [PMID: 20953399 PMCID: PMC2952335 DOI: 10.1155/2011/950795] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Revised: 06/21/2010] [Accepted: 08/07/2010] [Indexed: 11/18/2022]
Abstract
Acupuncture and meditation are promising treatment options for clinical pain. However, studies investigating the effects of these methods on experimental pain conditions are equivocal. Here, the effects of electroacupuncture (EA) and meditation on the submaximum effort tourniquet technique (SETT), a well-established, opiate-sensitive pain paradigm in experimental placebo research were studied. Ten experienced meditators (6 male subjects) and 13 nonmeditators (6 male subjects) were subjected to SETT (250 mmHG) on one baseline (SETT only) and two treatment days (additional EA contralaterally to the SETT, either at the leg on ST36 and LV3 or at the arm on LI4 and LI10 in randomized order). Numeric Rating Scale (NRS) ratings (scale 0-10) were recorded every 3 min. During baseline, meditation induced significantly greater pain tolerance in meditators when compared with the control group. Both the EA conditions significantly increased pain tolerance and reduced pain ratings in controls. Furthermore, EA diminished the group difference in pain sensitivity, indicating that meditators had no additional benefit from acupuncture. The data suggest that EA as a presumable bottom-up process may be as effective as meditation in controlling experimental SETT pain. However, no combined effect of both the techniques could be observed.
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Affiliation(s)
- Kyung-Eun Choi
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Frauke Musial
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Nadine Amthor
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Thomas Rampp
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Felix J. Saha
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Andreas Michalsen
- Department of Integrative and Complementary Medicine, Institute for Social Medicine, Epidemiology and Health Economics, Immanuel Hospital Berlin, Charité University Medical Center Berlin, 14109 Berlin, Germany
| | - Gustav J. Dobos
- Chair of Complementary and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany
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Bäcker M, Grossman P, Schneider J, Knoblauch NTM, Gareus IK, Hammes M, Linde K, Melchart D, Dobos GJ. Vegetative reaction to acupuncture in migraineurs depends on the vagal tone before treatment: a randomised, controlled trial. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2003.tb03970.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Theysohn N, Choi A, Gizewski ER, Dobos GJ, Forsting M, Musial F. Schmerzverarbeitung unter Akupunktur – eine fMRT Studie. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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