Journal of Integrative and Complementary Medicine

The goal of the methodological approach of "quality profiling" for complementary and alternative medicine (CAM) is to offer an empirical database that would enable different participants in the health care system to evaluate the quality of a medical provider.

Quality profiling is a structured way of describing quality on the levels of infra-structure, patients, medical interventions, outcomes, and quality assurance related to one specific provider. As part of a program called "quality management and research," this type of profiling constitutes one basic step for generating knowledge in terms of evidence-based medicine as well as confidence-based medicine. Quality profiling is exemplified by a hospital for Traditional Chinese Medicine in Germany. Within 1 year all in-patients were included in the database using questionnaires for physicians and patients at the time of admission, discharge from the hospital, and follow-up inquiries at intervals up to 1 year after discharge. The frequency of diagnostic and therapeutic interventions was recorded daily.

Data for 1036 patients (mean age 53 years old, 73% female) were analyzed. The most frequent diagnostic categories were musculoskeletal disorders (30%) and neurologic disorders (26%). Therapeutic effects were shown in various outcome measures such as reduced intensity of complaints, improved quality of life, increased satisfaction in lifestyle areas, and fewer days off work. In 6.5% of the subjects, adverse events (mostly of minor severity) were recorded.

Quality profiles can serve as a basic tool for evaluating provider quality when the results are compared with either a predefined standard or with profiles of other providers who are offering similar medical services.

The objectives of this study were to examine the distributions of nitric oxide (NO) in the skin points (acupoints)/meridian regions and determine whether neuronal nitric oxide synthase(nNOS) protein levels were associated with NO concentrations in the areas.

Low skin resistance points (LSRP) on the skin surface in response to electrical stimuli were performed in anesthetized adult rats. The skin together with subcutaneous tissue was isolated in meridian regions from PC 2 to 6, BL 36 to 57, CV 3 to 22, and GV 2 to 14. Control skin tissues were obtained in the areas close to related meridians without containing LSRP. Concentrations of nitrite (NO₂ ^-), nitrate (NO₃ ^-), and total NO₂ ^- plus NO₃ ^-(NO_x ^-) were quantified in the skin tissues, micropunches of brain nuclei, and blood vessels in a blinded fashion. Western blots were also conducted using polyclonal anti-nNOS and anti-endothelial nitric oxide synthase (eNOS) antibody in the skin tissues.

NO_x ^- and NO₃ ^- concentrations were higher (45 ± 8% and 43 ± 7% in the CV, 47 ± 7% and 51 ± 9% in the BL, and 47 ± 8% and 45 ± 6% in the PC) than those in control regions (p < 0.05, n = 6). NO_x ^- concentrations are 2- to 3-fold greater in skin tissues than those in brain regions and blood vessels (p < 0.05, n = 6-8). nNOS protein levels were consistently increased in the skin regions of BL, PC, and GV meridians compared with their controls (p < 0.05, n = 5-7) but endothelial NO synthase expression was not changed.

This is the first evidence showing that NO contents and nNOS expression are consistently higher in the skin acupoints/meridians associated with low electric resistance. The results suggest that enhanced NO in the acupoints/meridians is generated from multiple resources including neuronal NOergic system, and NO might be associated with acupoint/meridian functions including low electric resistance.

This study was designed to evaluate the effects of weak-intensity extremely high frequency (EHF) microwaves in a model system—the plant organism pollen grain—lacking the placebo effect, available in large populations, to ensure accurate statistical analysis, and whose sensitivity is closely relevant to animal and human biology.

This study was blinded using anin vitro pollen germination technique.

Pollen of kiwifruit (Actinidia deliciosa) was either directly irradiated or grown in a medium prepared with irradiated water, using a CromoStim 2000,^® (PromoPharma, Republic of San Marino) designed for EHF microwave resonance therapy (MRT). It produces weak intensity EHF radiations (40-78 GHz), either continuous wave (cw) or modulated, at a 10 Hz-frequency, with infrared (IR) carried to 635-950 nm, and with an impedance (IPD) of 10^-21 W/Hz cm² and a power supply from 0 to 20 mW.

Pollen-tube emergence was expressed as a percent of grains producing a tube and tube elongation was measured at 4 hours of incubation by a turbidimetric assay (A₅₀₀) of cultures, expressed as the net absorbance increase over time 0.

At days 2 and 4 during aging, both percent of germination and tube growth significantly and consistently improved over controls in kiwifruit pollen grains irradiated for 30 minutes at day 0 at 10 Hz frequency with the CromoStim 2000. Highly significant effects, either stimulant or inhibitory, were also observed on kiwifruit pollen(stressed or not) growing in a medium prepared with water previously irradiated either cw or modulated. Irradiated water affected pollen germination immediately and even after several days following EHF treatment.

Either direct or indirect EHF irradiation performed by the CromoStim 2000 is effective on pollen growth processes. In both cases, water seemed to play a primary role. According to the quantum electrodynamical coherence theory, our work could also have implications for homeopathy, suggesting a key to explain the efficacy of high dilutions and succussion procedures.

Electrodermal measurements with a Ryodoraku instrument were used to monitor the effects of a 2-day qigong workshop on the body energy of participants.

Measurements were made of the relative electrical conductivity of 24 acupuncture points on the wrists and feet of 29 subjects. Each subject was measured in the morning and afternoon of each day, and the subjects served as their own control.

The standard deviation of the mean values of the Ryodoraku responses of individuals and of the group were less in the afternoons than in the mornings with p-values of 0.004 and 0.0001 for the first and second days, respectively. The decreases in the values of the standard deviations indicate that the balance of the body energy of individuals and the group had improved, presumably as a result of the workshop. We also found that all Ryodoraku responses were significantly greater in the afternoons than in the mornings, a result that is attributed to a circadian rhythm.

The improved balance of qi energy in the body of the participants indicates that qigong practice has the potential to improve health. Electrodermal measurements for monitoring Eastern and Western therapies are discussed.

Complementary and alternative medicine have become an increasingly topical theme in respiratory medicine. Aromatics are a commonly used ingredient in a number of proprietary medicines. It is well established that lung mucus clearance is impaired in patients with chronic airways obstruction. This study investigated whether aromatics delivered by inunction could be objectively shown to enhance lung clearance.

We studied 12 patients with chronic bronchitic with a mean standard error (SE) age of 67 (2) years (mean [SE] tobacco consumption history of 64 [12] pack-years). We used a randomized, single-blinded, placebo-controlled crossover trial within patient design assessing the effect of 7.5 g of aromatics inunction (compared to a "no-treatment baseline" and to a petrolatum"placebo") on lung mucus clearance measured by a standard radioaerosol technique.

Aromatic treatment significantly enhanced clearance at two time points 30 (p < 0.05) and 60(p < 0.02) minutes postradioaerosol inhalation but had no demonstrable further effect over the following 5 hours despite further application of the inunction. The clearance improvement (relative to a baseline) observed during the first hour of testing was significantly correlated (p < 0.01) with the concentration level of aromatics.

Our data, thus, provide objective evidence of a positive effect of aromatics inunction on mucus clearance in chronic airways obstruction.

Ozone therapy is being used to treat ischemic disorders. However, the underlying mechanisms for the success are unknown and the therapy has not been accepted fully within conventional medicine. This study sought to assess the effect of ozone therapy on resting muscle oxygenation.

Twenty-three (23) patients and 3 volunteers were recruited for this prospective study. Systemic ozone therapy was administered by autohemotransfusion on three alternate days over 1 week. Tissue oxygenation (mmHg) was directly measured in the tibialis anterior muscle using polarographic needle electrodes before and after the first and the third ozone therapy session.

Globally, the differences in oxygenation were not statistically significant but there was a significant decrease in the percentage of low-oxygenated values (pO₂ < 5 mmHg) following ozone sessions (p < 0.02). The change in muscle oxygenation following ozone therapy was inversely correlated with age (r = -0.398; p = 0.044) and with the initial (baseline pretherapy) muscle oxygenation values (r = -0.644; p < 0.001), indicating that the more poorly oxygenated muscles benefited most from the therapy. A significant (p = 0.031) higher oxygenation in these tissues was observed 48 hours after the second session.

Ozone therapy can modify oxygenation in resting muscles, particularly of those that are most hypoxic. Our results suggest that ozone therapy could be used effectively as a complementary treatment of hypoxic and ischemic syndromes and that the therapy warrants further investigation for possible application in other clinical conditions.

Apart from its claims for improvement of sexual functions in men, the puncturevine plant (Tribulus terrestris: TT) has long been considered as an energizer and vitalizer in the indigenous system of medicine. Sexual behavior and intracavernous pressure (ICP) measurements were taken in rats to scientifically validate the claim of TT [containing protodioscin (PTN)] as an aphrodisiac.

Forty sexually mature male Sprague-Dawley rats were randomly divided into four groups of 10 each. Group I served as a control group and groups II, III, and IV were treated with three different doses of TT extract (2.5, 5 and 10 mg/kg body weight, respectively), orally, once daily for 8 weeks. Weight was recorded and the rats from all four groups were subjected to sexual behavior studies with primed females and various parameters namely mount and intromission frequencies (MF and IF, respectively), mount, intromission and ejaculation latencies (ML, IL, and EL, respectively) as well as postejaculatory interval (PEI) were recorded. In addition, blood pressure and ICP were recorded for all rats at the end of study.

Increases in body weight (by 9, 23, and 18% for groups II, III & IV) and ICP (by 43% and 26% for groups III and IV) were statistically significant compared to the control group. Increases in MF (by 27% and 24%) and IF (by 19% and 22%) for the groups III and IV were statistically significant. Decreases in ML (by 16%, 23%, and 22% for groups II, III, and IV) and PEI (by 20% for group III) were statistically significant compared to the control.

The weight gain and improvement in sexual behavior parameters observed in rats could be secondary to the androgen increasing property of TT (PTN) that was observed in our earlier study on primates. The increase in ICP which confirms the proerectile aphrodisiac property of TT could possibly be the result of an increase in androgen and subsequent release of nitric oxide from the nerve endings innervating the corpus cavernosum.

Honey is an effective antiseptic wound dressing, mainly the result of the antibacterial activity of hydrogen peroxide that is produced in honey by the enzyme glucose oxidase. Because the rate of production of hydrogen peroxide is known to vary disproportionately when honey is diluted, and dilution of honey dressings will vary according to the amount of wound exudate, it is important to know more about the production of hydrogen peroxide at different concentrations of honey.

The rates of hydrogen peroxide production by honey with respect to honey dilution were measured in eight different samples of honey from six different floral sources.

Honey Research Unit, Waikato University, Hamilton, New Zealand.

The maximum levels of accumulated hydrogen peroxide occurred in honey solutions diluted to concentrations between 30% and 50% (v/v) with at least 50% of the maximum levels occurring at 15-67% (v/v). This is equivalent to a 10 cm × 10 cm dressing containing 20 mL of honey becoming diluted with 10 to 113 mL of wound exudate. Maximum levels of hydrogen peroxide reached in the diluted honeys were in the range of 1-2 mmol/L.

Significant antibacterial activity can be maintained easily when using honey as a wound dressing, even on a heavily exuding wound. Concentrations of hydrogen peroxide generated are very low in comparison to those typically applied to a wound, thus, cytotoxic damage by hydrogen peroxide is very low.

To compare the attitudes about complementary and alternative medicine (CAM) of medical students from two different medical schools and at different stages of their medical training (first and third years).

Four-group, cross-sectional, self-administered survey study.

Three hundred and eleven (311) students from two British medical schools(Newcastle and London).

Self-reported knowledge of, attitudes about, and beliefs about CAM.

Third-year students thought CAM overall was less effective than first-year students and also were significantly less interested in training in CAM techniques. The 43 attitude statements factored into six interpretable factors. A medical school × year ANOVA on the factor scores showed many results consistent with the first part of the study. First-year students seemed more eager to be taught CAM than third-year students, and students at Newcastle were more positive about CAM than those at University College London.

Education at medical school does influence attitudes to CAM. As their orthodox medical training proceeds, medical students seem to increase their skepticism about CAM.

To investigate the safety and efficacy of Throat Coat^® (Traditional Medicinals,^® Sebastopol, CA), a traditional demulcent herbal tea, in comparison with a placebo tea in the symptomatic treatment of acute pharyngitis.

Multicenter, prospective, randomized, double-blinded, placebo-controlled, two-armed, parallel-group clinical trial.

Three primary care clinics in Duluth, MN, Madison, WI, and Middleton, WI.

Patients of both genders (≥18 years of age) with clinical diagnoses of acute pharyngitis.

Patients(n = 60) were randomly assigned to receive 5-8 oz of Throat Coat (n = 30) or a placebo (n = 30), four to six times daily. The study period was 2 to 7 days with a window for the follow-up visit of 2-10 days accounting for the variable duration of sore throat symptoms.

Primary efficacy parameter: sum of pain intensity differences (SPID) for pain in throat on swallowing, calculated as the area under the curve (AUC) of pain intensity difference scores (assessed at 1 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 30 minutes after treatment). Secondary efficacy parameter: total pain relief (TOTPAR), calculated as the AUC from time 0 (baseline) to 30 minutes of pain relief (assessed at 1 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 30 minutes).

Compared to placebo, intensity of throat pain when swallowing was significantly reduced by Throat Coat in intention to treat and valid for efficacy analysis (VEA). Significant differences in change from baseline pain were observed at 5 min (p = 0.007), 10 min (p = 0.005), 15 minutes (p = 0.01), 20 minutes (p = 0.05), and 30 minutes (p = 0.04) after completion of the first dose (VEA analysis). There was a statistically significant improvement of SPID in the Throat Coat-treated group: Least square means ± standard error of the means (SEM) of SPID were -16.5± 13.9 in the placebo group and -43.8 ± 11.9 in the Throat Coat-treated group (p = 0.012). TOTPAR was also significantly higher in the Throat Coat-treated group: Least square means ± SEM of TOTPAR were 32.4 ± 12.8 in the placebo group and 53.6 ± 10.9 in the Throat Coat-treated group (p = 0.031). This study shows that Throat Coat is significantly superior to placebo and provided a rapid, temporary relief of sore throat pain in patients with pharyngitis.

A treatment for patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is presented, which is based on an isopathic method that appears to be effective in eliminating bacterial antigens from the body. The concept is based on a new hypothesis concerning the outbreak and spread of AIDS in Africa and worldwide.

Laboratory data are presented from five European and seven African patients with HIV.

Oral administration of ultra-low doses of a lysate of Staphylococcus aureus Cowan I (12c potency) resulted in a significant increase of CD4 T-cell subsets and CD4/CD8 ratios in patients with HIV infection as well as in advanced stages of HIV disease, concomitant with the improvement of clinical HIV-related symptoms.

Based on epidemiologic data, the beginning of the African AIDS epidemic is related—to time, place, and circumstances—to the initial large-scale introduction of antibiotics in areas of Central Africa that would later comprise the AIDS belt. It is concluded that certain antimicrobial agents can enhance the formation of persistent bacterial superantigens, which may indicate a link between asymptomatic HIV carriers and the development of AIDS. According to this view, superantigens and bacterial cell wall components remaining in the body after antibiotic treatment cause a permanent activation of the immune system and would thus favor T-cell infection and viral replication in HIV-infected individuals.