Evidence-based Complementary and Alternative Medicine - current issue

eCAM: A Closer Look at Clinical Analyses

Cooper, E. L. — Wed, 05 Aug 2009 06:45:29 PDT

Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

Vojdani, A., Hebroni, F., Raphael, Y., Erde, J., Raxlen, B. — Wed, 05 Aug 2009 06:45:29 PDT

Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage of in vivo induced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis.

Cost Effectiveness of Natural Health Products: A Systematic Review of Randomized Clinical Trials

Kennedy, D. A., Hart, J., Seely, D. — Wed, 05 Aug 2009 06:45:29 PDT

Health care spending in North America is consuming an ever-increasing share of Gross Domestic Product (GDP). A large proportion of alternative health care is consumed in the form of natural health products (NHPs). The question of whether or not NHPs may provide a cost-effective choice in the treatment of disease is important for patients, physicians and policy makers. The objective of this study was to conduct a systematic review of the literature in order to find, appraise and summarize high-quality studies that explore the cost effectiveness of NHPs as compared to conventional medicine. The following databases were searched independently in duplicate from inception to January 1, 2006: EMBASE, MEDLINE, CINAHL, BioethicsLine, Wilson General Science abstracts, EconLit, Cochrane Library, ABI/Inform and SciSearch. To be included in the review, trials had to be randomized, assessed for some measure of cost effectiveness and include the use of NHPs as defined by the Natural Health Products Directorate. Studies dealing with diseases due to malnutrition were excluded from appraisal. The pooled searches unveiled nine articles that fit the inclusion/exclusion criteria. The conditions assessed by the studies included three on postoperative complications, two on cardiovascular disease, two on gastrointestinal disorders, one on critically ill patients and one on urinary tract infections. Heterogeneity between the studies was too great to allow for meta-analysis of the results. The use of NHPs shows evidence of cost effectiveness in relation to postoperative surgery but not with respect to the other conditions assessed. In conclusion, NHPs may be of use in preventing complications associated with surgery. The cost effectiveness of some NHPs is encouraging in certain areas but needs confirmation from further research.

Ten Years Evidence-based High-Tech Acupuncture-A Short Review of Centrally Measured Effects (Part II)

Litscher, G. — Wed, 05 Aug 2009 06:45:29 PDT

The assessment of acupuncture-induced effects on brain function is crucial. Ultrasound-assisted brain function monitoring and bioelectrical methods as well as near infrared spectroscopic procedures and functional magnetic resonance investigations form the basis for the latest scientific examination methods for acupuncture research. The laserneedle acupuncture, which was examined scientifically for the first time in Graz, represents a new painless and non-invasive acupuncture method. In this way, individual combinations of acupuncture points can be stimulated simultaneously according to traditional Chinese medicine. In the context of double-blind studies, effects in the brain could be demonstrated in a reproducible manner for the first time. This second part of the short review article summarizes some of the centrally measured effects of acupuncture obtained at the Medical University of Graz within the last 10 years.

The Methyltetrahydro-{beta}-Carbolines in Maca (Lepidium meyenii)

Gonzales, G. F., Gonzales-Castaneda, C. — Wed, 05 Aug 2009 06:45:29 PDT

Maca, a plant native to the Peruvian highlands, contains (1R,3S)-1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid (MTCA). The family of the tetrahydro-β-carbolines has been associated with both biologically helpful and harmful compounds. We present evidence that MTCA is a natural constituent of Maca, and on consumption no toxicity is found. This suggests that, when consumed as multi-component, MTCA may loose its adversity as drug action.

Ficus racemosa Stem Bark Extract: A Potent Antioxidant and a Probable Natural Radioprotector

Wed, 05 Aug 2009 06:45:29 PDT

Ethanol extract (FRE) and water extract (FRW) of Ficus racemosa (family: Moraceae) were subjected to free radical scavenging both by steady state and time resolved methods such as nanosecond pulse radiolysis and stopped-flow spectrophotometric analyses. FRE exhibited significantly higher steady state antioxidant activity than FRW. FRE exhibited concentration dependent DPPH, ABTS^•–, hydroxyl radical and superoxide radical scavenging and inhibition of lipid peroxidation with IC₅₀ comparable with tested standard compounds. In vitro radioprotective potential of FRE was studied using micronucleus assay in irradiated Chinese hamster lung fibroblast cells (V79). Pretreatment with different doses of FRE 1h prior to 2 Gy -radiation resulted in a significant (P < 0.001) decrease in the percentage of micronucleated binuclear V79 cells. Maximum radioprotection was observed at 20 µg/ml of FRE. The radioprotection was found to be significant (P < 0.01) when cells were treated with optimum dose of FRE (20 µg/ml) 1 h prior to 0.5, 1, 2, 3 and 4 Gy -irradiation compared to the respective radiation controls. The cytokinesis-block proliferative index indicated that FRE does not alter radiation induced cell cycle delay. Based on all these results we conclude that the ethanol extract of F. racemosa acts as a potent antioxidant and a probable radioprotector.

Modified Wendan Decoction can Attenuate Neurotoxic Action Associated with Alzheimer's Disease

Liu, P., Zhao, L., Zhang, S.-L., Xiang, J.-Z. — Wed, 05 Aug 2009 06:45:29 PDT

We observed the effect of modified Wendan decoction (modified Wen-Dan-Tang) on a cellular model of Alzheimer's disease. Amyloid beta (Aβ) 25–35 segment neurotoxin was employed to induce a PC12 cellular model of Alzheimer's disease. After modified Wendan decoction was fed to rats, the serum containing medicine was prepared and changes in cell morphology observed. Cell mortality and survival rate was examined by trypan blue stain assay and MTT method and caspase-3 expression was detected by western blot, while cell apoptosis was examined by flow cytometry. Cell morphology of prepared serum group was better than that of controls, and cell survival rate in prepared serum group was higher than that in control (P < 0.01 or P < 0.05). Cell mortality, caspase-3 expression and apoptosis rate in prepared serum group were lower than that in control (P < 0.01 or P < 0.05). We conclude that Modified Wendan Decoction can attenuate the neurotoxicity of Aβ 25–35 and rescue neurons via suppressing apoptotic process.

Phytic Acid Exposure Alters AflatoxinB1-induced Reproductive and Oxidative Toxicity in Albino Rats (Rattus norvegicus)

Abu El-Saad, A. S., Mahmoud, H. M. — Wed, 05 Aug 2009 06:45:29 PDT

The increased use of feed in Egypt's aquaculture and animal industries raises concerns about the possible presence of mycotoxins in feedstuffs. The use of alternative medicine, such as botanicals and nutritional supplements, has become popular with inflammatory cases. The present study aimed to testify the role played by phytic acid (IP6) in enhancing the reproductive and oxidative toxicity induced in aflatoxinB1 (AFB1) treated white male albino rats (Rattus norvegicus) throughout treatment and withdrawal periods. One hundred and twenty white male albino rats were grouped into four groups. Group 1, was injected with 300 µg kg^–1 body wt of AFB1 once every 3 days for 15 days and left uninjected for another 15 days to study the withdrawal effect. Group 2, was injected with 300 µg kg^–1 body wt of AFB1 once every 3 days for 15 days and treated simultaneously with IP6 daily for another 15 days. Group 3, was treated daily with IP6 (40 mg kg^–1 body wt) for 15 days and with no treatment for other 15 days. Group 4, injected with equivalent volume of sterile phosphate buffer saline solution as a control group. Sera were taken at the experimental intervals and assayed for testosterone hormone, follicular-stimulating hormone (FSH) and luteinizing hormone (LH) to determine the toxicological impact of AFB1 and the possibility of amelioration by phytic acid on the reproductive performance of the studied animal. The effects of AFB1 treatment on the absolute and relative weight of testis as well as its histopathologic effect on the testis and the possibility of amelioration by IP6 treatment were evaluated. The activities of enzymatic and non-enzymatic anti-oxidants, in addition to lipid peroxidation were measured in the testis’ homogenate of AFB1-treated rats. A decrease in sex hormone levels, an increase in testicular lipid peroxidation product levels and a significant decrease in testicular glutathione content, catalase and total peroxidase and superoxide dismutase activities were recorded. The histopathologic alterations revealed a degeneration and highly mitotic division within the spermatogenic nuclei, in addition to some karyomegaly and nuclear pyknosis. It is concluded that the reduction in the toxicity of free radicals by phytic acid might be responsible for the protective influence observed.

Crocus Sativus L. (Saffron) Extract and its Active Constituents (Crocin and Safranal) on Ischemia-Reperfusion in Rat Skeletal Muscle

Hosseinzadeh, H., Modaghegh, M. H., Saffari, Z. — Wed, 05 Aug 2009 06:45:29 PDT

Saffron and its constituents have been shown to decrease ischemia-reperfusion (I/R) injury in kidney or brain tissues. In this study, the effects of saffron ethanolic extract and its constituents, crocin and safranal, were evaluated in skeletal muscle during I/R injury. Hind limb ischemia was induced using clamping the common femoral artery and vein. After 2 h ischemia, the clamp of the femoral vessels of animals was taken off and the animal underwent 1h reperfusion. Muscle injuries were evaluated by recording of the electromyographic (EMG) potentials and performing some biochemical analysis including thiobarbituric acid reactive substances (TBARS), total sulfhydryl (SH) groups and antioxidant capacity of muscle (using FRAP assay). The ethanolic extract of saffron (5, 20 and 80 mg kg^–1), crocin (50, 200 and 400 mg kg^–1), safranal (0.1, 0.25 and 0.5 ml kg^–1) and normal saline (10 ml kg^–1) were administered intraperitoneally 1 h prior reperfusion. The average peak-to-peak amplitude during I/R was significantly increased in extract, crocin and safranal groups in comparison with control-ischemic group. Following saffron, crocin and safranal administration, the total SH contents and antioxidant capacity were elevated in muscle flap. The MDA level was declined significantly in test groups. It is concluded that saffron extract and its constituents show a protective effect against lower limb I/R in rat.

Evaluation of the Wound-healing Activity of Ethanolic Extract of Morinda citrifolia L. Leaf

Nayak, B. S., Sandiford, S., Maxwell, A. — Wed, 05 Aug 2009 06:45:29 PDT

Morinda citrifolia L. (noni) is one of the most important traditional Polynesian medicinal plants. The primary indigenous use of this plant appears to be of the leaves, as a topical treatment for wound healing. The ethanol extract of noni leaves (150 mg kg^–1 day^–1) was used to evaluate the wound-healing activity on rats, using excision and dead space wound models. Animals were randomly divided into two groups of six for each model. Test group animals in each model were treated with the ethanol extract of noni orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, time until complete epithelialization, granulation tissue weight and hydoxyproline content. On day 11, the extract-treated animals exhibited 71% reduction in the wound area when compared with controls which exhibited 57%. The granulation tissue weight and hydroxyproline content in the dead space wounds were also increased significantly in noni-treated animals compared with controls (P < 0.002). Enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content and histological characteristics suggest that noni leaf extract may have therapeutic benefits in wound healing.

Improvement of Experimentally Induced Hepatic and Renal Disorders in Rats using Lactic Acid Bacteria-fermented Soybean Extract (BiofermenticsTM)

Shin, R., Suzuki, M., Mizutani, T., Susa, N. — Wed, 05 Aug 2009 06:45:29 PDT

The effects of lactic acid bacteria-fermented soybean extract (Biofermentics^TM; BF) on experimental models of hepatic and renal disorders were investigated in vivo and in vitro. In rat, hepatitis induced by feeding of deoxycholic acid (DCA, 0.5 wt/wt, n = 6) or intraperitoneal injection of d-galactosamine (GMN, 500 mg/body wt, n = 6), the increase in serum AST (aspartate aminotransferase) and ALT (alanine aminotransferase) levels were inhibited significantly (P < 0.05) by feeding a diet containing 5% dried BF. Moreover, the BF-administered rat group showed lower concentrations of blood urea nitrogen and a larger amount of urine as compared with values in the control group. Pretreatment of primary cell cultures of rat hepatic and renal cells with BF prior to exposure to dichromate (K₂Cr₂O₇) resulted in a marked decrease of dichromate-induced cytotoxicity as evaluated by the leakage of lactate dehydrogenase The levels of dichromate-induced lipid peroxidation, as monitored by malondialdehyde formation, were also reduced by pretreatment of hepatocytes with BF. These results suggest that BF may play a role in hepatic and renal disorders, and may be useful for maintaining health in humans as well.

Evaluating Complementary Therapies for Canine Osteoarthritis Part I: Green-lipped Mussel (Perna canaliculus)

Hielm-Bjorkman, A., Tulamo, R.-M., Salonen, H., Raekallio, M. — Wed, 05 Aug 2009 06:45:29 PDT

A green-lipped mussel (GLM) preparation was evaluated in a randomized, double-controlled and double-blinded clinical trial. It was hypothesized that the treatment effect would be less than that of the positive control (carprofen) but more than that of the negative control (placebo). Forty-five dogs with chronic pain and a radiographic diagnosis of osteoarthritis that were randomly allocated into one of three groups completed the study. All dogs were fed the test products or placebo for 8 weeks. The dogs were evaluated four times, at 4-week intervals. Six different variables were assessed: veterinary-assessed mobility index, two force plate variables, owner-evaluated chronic pain index and pain as well as locomotion visual analogue scales (VASs). Intake of extra carprofen was also evaluated. A chi-squared and a Mann–Whitney test were used to determine significance between groups. When changed to dichotomous variables, there were more dogs in the GLM than in the placebo group that improved, according to veterinary-assessed mobility, owner-evaluated chronic pain index and pain VAS (P = 0.031, P = 0.025, P = 0.011, respectively). For the same three, the odds ratio and their confidence interval were over one. The extent of improvement was significantly different between the GLM and the control in veterinary-assessed mobility (P = 0.012) and pain VAS (P = 0.004). In conclusion, GLM alleviated chronic orthopedic pain in dogs although it was not as effective as carprofen. As no side-effects were detected, GLM may be beneficial in dogs e.g. when non-steroidal anti-inflammatory drugs cannot be used.

Hangekobokuto (Banxia-houpo-tang), a Kampo Medicine that Treats Functional Dyspepsia

Oikawa, T., Ito, G., Hoshino, T., Koyama, H., Hanawa, T. — Wed, 05 Aug 2009 06:45:29 PDT

Although abdominal bloating is one of the most bothersome symptoms experienced by patients with functional dyspepsia (FD), therapeutic drugs to relieve abdominal bloating have not been established. We investigated the Kampo (Chinese herbal) medicine, Hangekobokuto (Banxia-houpo-tang, HKT) for patients with FD from the standpoint of bowel gas retention. The bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients was significantly higher than that in healthy subjects. Two week administration of HKT in the FD patients showed a significant decrease of GVS. Furthermore, gastrointestinal symptoms, especially symptoms of abdominal pain, indigestion and constipation, all of which are closely related to abdominal bloating, improved significantly in FD patients after the administration of HKT. These results suggest that HKT improves abdominal bloating accompanied by the reduction of bowel gas in FD patients.

How Far Can Ki-energy Reach?--A Hypothetical Mechanism for the Generation and Transmission of Ki-energy

Ohnishi, S. T., Ohnishi, T. — Wed, 05 Aug 2009 06:45:29 PDT

‘Ki-energy’, which can be enhanced through the practice of Nishino Breathing Method, was reported to have beneficial health effects. Although Ki-energy can play an important role in complementary and alternative medicine (CAM), as yet it is unknown how Ki-energy is generated, transmitted through air and received by another individual. We previously proposed that Ki-energy may include near-infrared radiation, and that the wavelength was between 800 and 2700 nm. Since Ki-energy is reflected by a mirror, we believe that the ‘Ki-beam’ has a small divergence angle. It can also be guided in a desired direction. The acrylic mirror reflection experiment suggests that the wavelength may be between 800 and 1600 nm. Using a linear variable interference filter, we found that Ki-energy may have a peak around 1000 nm. We have also observed that ‘sensitive’ practitioners responded to Ki sent from a distance of 100 m. All of these results suggest that (i) Ki-energy can be guided as a directional ‘beam’ with a small divergence angle; (ii) the beam can be reflected by a mirror and (iii) Ki-energy may have a specific wavelength. Since these properties are characteristics of the laser radiation, we propose a quantum physics-based mechanism of ‘Light Amplification by the Stimulated Emission of Radiation’ (i.e. LASER) for the generation of Ki-energy. Volunteers responded to Ki even with a blindfold. This suggests that the skin must be detecting Ki-energy. We propose that the detector at the skin level may also have the stimulated emission mechanism, which amplifies the weak incident infrared radiation.

Effective Application of Knowledge Management in Evidence-based Chinese Medicine: A Case Study

Yang, A. W., Allan, G., Li, C. G., Xue, C. C. — Wed, 05 Aug 2009 06:45:29 PDT

Chinese medicine (CM) practice, as a knowledge-based industry, has not embraced knowledge management (KM) techniques widely. However, KM may facilitate the adaptation and promotion of evidence-based CM. A KM framework was introduced to its activities in evidence-based CM through the development of a CM portal. A codification strategy was used to codify and store knowledge systematically in a database. Several approaches were developed and implemented to address specific needs for CM such as centralizing the information, encouraging collective efforts, promoting integration of explicit and tacit knowledge, and developing a flexible technology and support system. Following the established KM framework, the RMIT Chinese Medicine Portal (www.chinese-medicine.com.au) was built up with four major components: organizational knowledge, knowledge workers, KM processes and information technology. Knowledge on Chinese herbs was classified into core, advanced and innovative categories, which involved the development of the monograph template. A working group was organized including CM, pharmacology and information technology professionals to implement this proposal with following sequential development stages: knowledge creation/acquisition, storage/organization, distribution and application. User interface and web language were also defined and accomplished. This case study demonstrates the applicability of KM in evidence-based CM through a multidisciplinary collaboration, such as, an effective collaboration between CM and information technology. The study also shows the potential of KM application in other disciplines of complementary and alternative medicine.

Turo (Qi Dance) Training Attenuates Psychological Symptoms and Sympathetic Activation Induced by Mental Stress in Healthy Women

Lee, H.-J., Chae, Y., Park, H.-J., Hahm, D.-H., An, K., Lee, H. — Wed, 05 Aug 2009 06:45:29 PDT

Vagal withdrawal and sympathetic overactivity accompany various types of stress. Qi training is reported to reduce sympathetic hyper-reactivity in a stressful situation. Turo, which is a type of dance that uses the Meridian Qi System, may reduce the psychological symptoms induced by an imbalance of the autonomic nervous system (ANS). We observed whether Turo training alters psychopathological and psychological symptoms using the Symptom Checklist 90-Revision (SCL-90-R) and examined whether it attenuates the stress response to mental stress in healthy adolescent females using the power spectrum analysis of heart rate variability (HRV). Twenty-one subjects received Turo training and 27 subjects were trained with mimicking movements. The SCL-90-R was measured before and after the 2-month training period. Heart rate (HR), total power (TP) and the LF/HF ratio of HRV were compared between the Turo and control groups during and after mental stress. The somatization and hostility subscales of the SCL-90-R of the Turo group were significantly lower than those of the control group after 2 months. The increases in HR and the LF/HF ratio of HRV induced by the stress test were significantly lower in the Turo group than in the control group. The TP of the Turo group was significantly higher than that of the control group. The psychological symptoms and sympathetic activation induced by the artificial stress were significantly reduced by the Turo training. These findings suggest that Turo training can play a critical role in attenuating psychological symptoms and stress-induced sympathetic activation.

Brief Homeopathic Pathogenetic Experimentation: A Unique Educational Tool in Brazil

Teixeira, M. Z. — Wed, 05 Aug 2009 06:45:29 PDT

In homeopathy, many difficulties are encountered in understanding theoretical presuppositions because they represent different paradigms from those of hegemonic science. In our medical school, we developed a brief homeopathic pathogenetic experimentation course to be added as curricular content and a didactic method in homeopathic disciplines to add practical experience to the theoretical approach of homeopathic presuppositions. In accordance with the premises laid out by Hahnemann, the father of homeopathy, brief pathogenetic experimentation was offered on a voluntary basis for students who were free of chronic diseases and who had not regularly used medication in the last 3 months. The clinical test, either crossed or sequential (randomized and blind), was used as a study model. Single weekly doses of a homeopathic medicine of 30 cH or placebo were taken by participants during 4 weeks after which crossover of the experimented substances took place for another 4 weeks. Polycrest medicines were used so that symptoms developed by the participants could be compared to those described in Homeopathic Materia Medica. Thirty-three of the 50 students who studied homeopathy as an elective discipline over the last 4 years at the School of Medicine of the University of São Paulo (FMUSP) participated. Participants described symptoms according to specific methodology including many comments with peculiar characteristics and notable idiosyncrasies. All these students endorsed the course because it contributed to their understanding of how dynamized substances produced symptoms in healthy participants as well as the cure of symptoms according to the casual similitude principle. Brief homeopathic pathogenetic experimentation proved to be an effective method to observe the idiosyncratic manifestations of human individuality based on qualitative methodology, thus building a basis of understanding of homeopathy.

Summary of the American College for Advancement in Medicine November 2007 Conference on Integrative Medicine: Advancing Science and Clinical Practice

Speight, N., Hynote, E. D. — Wed, 05 Aug 2009 06:45:29 PDT