News aggregator

Kampo in Women's Health: Japan's Traditional Approach to Premenstrual Symptoms.

J Altern Complement Med. 2008 May 8;

Authors: Gepshtein Y, Plotnikoff GA, Watanabe K

ABSTRACT Kampo is Japan's traditional herbal medicine and it is an integral part of the official Westernized medical system in Japan. We describe the Kampo approach to premenstrual symptoms. We present 3 clinical cases of women treated for premenstrual discomforts in a Kampo clinic in Japan. Each of these women reported improvement in their conditions. We argue that Kampo is well-suited for treatment of premenstrual symptoms in Japan and deserves the attention of Western clinicians for three reasons: (1) patient-centered Kampo diagnosis allows physicians to handle subjective and culture-bound symptoms that are often ignored by Western medicine; (2) Kampo herbal formulas are regulated by the Japanese government, and are pure and of high quality; and (3) the settings in which Kampo is practiced set a stage for therapeutic collaboration between the doctor and the patient.

PMID: 18466067 [PubMed - as supplied by publisher]

[Comparison of properties of Mahuang decoction and Maxing Shigan decoction based on biothermodynamics]

Zhongguo Zhong Yao Za Zhi. 2007 Mar;32(5):421-4

Authors: Fan DL, Liao QW, Yan D, Ma XJ, Xiao XH, Zhao YL

OBJECTIVE: To probe into the objectivity and authenticity of four properties beteen Mahuang decoction and Maxing Shigan decoction from biothermodynamics. METHOD: The power-time curves of growth of Staphylococcus aureus at different concentrations between Mahuang decoction and Maxing Shigan decoction were determined by TAM Air Isothermal Calorimeter. The growth rate constants of promotive and inhibitory actions were calculated. Moreover, the difference of properties beteen Mahuang decoction and Maxing Shigan decoction was analyzed from the point of view of TCM theory. RESULT: Both the Mahuang decoction and Maxing Shigan decoction could inhibit the growth and metabolism of Staphylococcus aureus. The k and Pm were decreased with the mass increase of the decoction. However, inhibitory activity of Mahuang decoction with warm property was weaker than that of Maxing Shigan decoction with cool property. Moreover, Mahuang decoction decreased heat output in growth metabolism more weakly than Maxing Shigan decoction. There was a stable difference between them. CONCLUSION: Studying on biothermodynamics can show the difference of four properties of Traditional Chinese Medicine. So, it provides a new and useful means for the study of the properties of traditional Chinese medicine.

PMID: 17511150 [PubMed - indexed for MEDLINE]

[Research progress of microparticles as drug delivery system for traditional Chinese medicine]

Zhongguo Zhong Yao Za Zhi. 2007 Mar;32(5):371-4

Authors: Li WH, He Y

Microparticle preparation, a new drug delivery system based on microencapsulation technique, includes micro-spheres and microcapsules. Recently, this new drug delivery system has been applied in developing new dosage forms for the traditional Chinese medicine (TCM). TCM microparticles can perform several sound characteristics and functions which are currently unavailable in TCM preparations, such as controlled release, effect of targeting, increasing bioavailability or low toxicity. This makes it possible that TCM may exert much higher therapeutic efficacy and show lower side-effects as well. Although the studies on TCM microparticles are still in the beginning stage, microparticle preparation of TCM has given rise to comprehensive attention and will have a wonderful prospect. The progress in this field is reviewed in this article.

PMID: 17511135 [PubMed - indexed for MEDLINE]

[Application of computerized virtual screening technique in traditional Chinese medicine]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):263-6

Authors: Zhu W, Chen KJ, Xu XJ

The rapid development of computer technology, molecular pharmacology and molecular biology extremely promoted the extensive and successful application of virtual screening technique (VST) in pharmaceutical exploitation. Based on plentiful literature and their own previous work, the authors elaborated the principles, methodology and strategy of VST systematically, gave a retrospection on the application of VST in the field of TCM in the last several years, and supposed that along with deepening of understanding, VST would play a greater role in TCM.

PMID: 17432695 [PubMed - indexed for MEDLINE]

[Clinical observation on treatment of radiation pneumonia by Qingjin Runfei Decoction combined with hormone and antibiotic]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):254-6

Authors: Zhang T, Ma SL, Yue JH

OBJECTIVE: To observe the curative effect of Qingjin Runfei Decoction (QRD) combined with hormone and antibiotic in treating radiation pneumonia (RP). METHODS: Patients were randomly assigned to two groups, the control group (51 cases) treated with hormone and antibiotic and the treated group (53 cases) with the above therapy plus QRD. The curative effects on RP, quality of life (QOL), chest radiography and TCM symptoms were observed. RESULTS: The curative effects on the above items in the treated group were all significantly better than those in the control group (P < 0.05). CONCLUSION: QRD could enhance the effects of hormone and antibiotic in treating RP, as well as improve QOL of the patients.

PMID: 17432692 [PubMed - indexed for MEDLINE]

[Clinical observation on treatment of chronic prostatitis syndrome type III B by Tiaoshen Tonglin Decoction]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):251-4

Authors: Li B, Jiang LJ, Chai J

OBJECTIVE: To observe the clinical effect of Tiaoshen Tonglin Decoction (TTD)) on chronic prostatitis syndrome (CPS) and its effects on urinary flow rate (UFR), uric acid (UA) content and pH value in expressed prostate secretions (EPS). METHODS: One hundred and eight patients with CPS were randomly assigned to two groups, the treatment group (56 cases) treated with TTI) and the control group (52 cases) with terazosin tablet, both for 60 days. The changes of chronic prostatitis symptom index (NIH-CPSL), established by the National Institutes of Health, U.S.A., UA and pH in EPS, as well as UFR were observed before and after treatment. RESULTS: The cure rate and the total effective rate in the treatment group were higher than those in the control group respectively (P < 0.05); after treatment, the UA level, pH value in EPS and NIH-CPSI decreased significantly in the treatment group (P < 0.01), lower than those in the control group, which had significant change (P < 0.05); the maximum UFR and average UFR of both groups were improved markedly after treatment (P < 0.05) with insignificant difference between the groups. CONCLUSION: TTD can improve the UFR, decrease the NIH-CPSI score, pH value and UA level in the EPS, is an effective recipe for treatment of CPS.

PMID: 17432691 [PubMed - indexed for MEDLINE]

[Clinical observation on effect of compound Shiwei Tablet in treating urinary tract infection]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):249-51

Authors: Zhan YL, Li XY, Wu SX

OBJECTIVE: To evaluate the safety and efficacy of Compound Shiwei Tablet (CST) in treating upper and lower urinary tract infection (UTI, pyretic stranguria of dampness-heat of the Lower-jiao type in 'TCM). METHODS: A multi-center, randomized, and opened clinical trial was conducted in the UTI patients with Sanjin Tablet (ST) as the parallel positive control medicine. The comprehensive efficacy, effect on TCM syndrome score, and change of urinary leukocyte count were observed, and the adverse reaction was recorded. RESULTS: In the 147 upper UTI cases and the 312 lower UTI cases after treatment, the comprehensive effect was higher and urinary leukocyte was less in the CST treated patients than in the ST treated patients (P < 0.05); but significant difference in the improvement of TCM symptoms was found between them only in the lower UTI cases ( P < 0.05); and no adverse reaction was observed during the treatment course. CONCLUSION: CST has definite therapeutic efficacy on UTI and is safe in clinical application.

PMID: 17432690 [PubMed - indexed for MEDLINE]

[Clinical observation on effects of therapeutic method of expelling wind, eliminating phlegm and promoting blood circulation in treating acute cerebral infarction in stroke unit]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):247-9

Authors: Fan YP, Xiong Y, Zhou Y

OBJECTIVE: To observe the effects of therapeutic method of expelling wind, eliminating phlegm and promoting blood circulation (EWEPPB) in treating acute cerebral infarction (ACI) depending on the clinical and data platform of stroke clinical unit. METHODS: ACI patients were randomly assigned to the control group (36 cases) treated by routine Western therapy alone and the treatment group (32 cases) with routine therapy plus Chinese medicinal compound for EWEPPB. The treatment course was 14 days. The scores of TCM symptom, the NIH stroke scale (NIHSS), and Barthel index (BI) were used for evaluating the effect of treatment. RESULTS: The scores of TCM symptom and NIHSS decreased, and that of BI increased after treatment in both groups, and the treatment in the treatment group showed a effect significantly better than that in the control group (P < 0.05). CONCLUSION: EWEPPB is effective method in treating ACI, traditional Chinese compounds for EWEPPB could play a positive role in the stroke unit.

PMID: 17432689 [PubMed - indexed for MEDLINE]

[Clinical observation on effect of modified Daotan Decoction combined with small dose risperidone in treating chronic schizophrenia]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):208-10

Authors: Liu JL, Ma L, Wang Y

OBJECTIVE: To evaluate the clinical efficacy of modified Daotan Decoction (DD) combining low dosage of risperidone in treating chronic schizophrenia patients of phlegm-dampness blockage type, and compare with patients treated with risperidone alone. METHODS: Sixty-five inpatients were randomly assigned to two groups, the treatment group (34 cases) treated with DD (with conventional dosage) one dose per day and risperidone 3.16 +/- 0.73 mg/d, and the control group (31 cases) treated with risperidone 5.11 +/- 1.27 mg/d alone, the course for both groups was 8 weeks. The effect was evaluated with positive and negative syndrome scale (PANSS), and the adverse reaction was assessed with treatment emergent symptom scale (TESS). RESULTS: There was no significant difference in the overall efficacy between the two groups, but the improvement of the negative symptoms, illness provocation and general psychopathologic condition was significantly better in the treatment group than that in the control group respectively (P < 0.05). Moreover, the adverse reaction was milder and less in the former than that in the latter. CONCLUSION: The treatment of DD combined with low dosage of risperidone is effective on chronic schizophrenia and shows less adverse reaction.

PMID: 17432677 [PubMed - indexed for MEDLINE]

[Study on integrated Chinese and Western therapy and criterion for efficacy evaluation of gastroesophageal reflux disease--a clinical observation on 116 cases]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):204-7

Authors: Xu HR, Bo P, Yuan Y

OBJECTIVE: To explore the criterion for efficacy evaluation of gastroesophageal reflux diseases (GERD) and the effect of treatment with integrated Chinese and Western medicine. METHODS: One hundred and sixteen patients of GERD were randomly assigned to two groups, group A treated with Western medicine and group B with integrated Chinese and Western medicine. Changes of symptoms, TCM syndromes, and endoscopic picture were observed before and after treatment. And the condition of recurrence was also inspected. RESULTS: The total effective rate was 84.5% and 67.2% in group A and B respectively. The long-term efficacy was better in group B than that in group A (P < 0.05), while there was no significant difference in short-term efficacy between the two groups. But the recurrence happened in both groups after withdrawal of treatment. The recurrence rate was significantly higher in patients of deficiency syndrome type and coexistence of deficiency and excess syndrome type than that in those of excess syndrome type (P < 0.05), and it was also higher in those whose pathogenesis was associated with mental factor (P < 0.05). In the other 20 patients the treatment was sustained for 10.4 +/- 11.4 months on average. There were 69.0% of the patients with normal esophagus mucosa shown by endoscope examination, and the pathological changes were not coincident with the symptoms and prognosis. CONCLUSIONS: Basically, no case of GERD could be cured, so, it is supposed that the item of "cure" in the criteria of therapeutic efficacy evaluation is advisably made over to "clinical control" or "obvious efficacy", and add an item of "no change" in the criterion. The importance of endoscopic picture for efficacy evaluation is doubtful and needs to be further discussed.

PMID: 17432676 [PubMed - indexed for MEDLINE]

[Effect of Danzhi Xiaoyao Powder on neuro-immuno-endocrine system in patients with depression]

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):197-200

Authors: Li YJ, Luo HC, Qian RQ

OBJECTIVE: To observe the effect of Danzhi Xiaoyao Powder (DXP) on neuro-immuno-endocrine system in patients with depression. METHODS: A randomized double-blinded and controlled study was conducted in 63 cases of depression. They were assigned to the DXP group (32 cases, treated with DXP) and the control group (31 cases, treated with maprotiline). The curative effect was evaluated with Hamilton's depressive scale (HAMD) before and at the end of the 2nd, 4th and 6th week of the treatment. Serum levels of serotonin (5-HT), norepinephrine (NE), brain derived neurotrophic factor (BDNF), cortisol (CORT), interleukin-6 (IL-6), and interleukin-1beta (IL-1beta) were detected before and at the 6th week of the treatment. RESULTS: After 2 weeks of treatment, the total score of HAMD decreased remarkably in both groups (P < 0.01), and the total score, as well as the scores of the three factors, i. e. anxiety/somatization, cognitive impairment and feeling of despair, were lower in the DXP group than that in the control group respectively (P < 0.05 or P < 0.01). After 4 and 6 weeks of treatment the total score and score of the three factors all reduced significantly in both groups (P < 0.01), with insignificant difference between the groups. After 6 weeks of treatment, the serum levels of 5-HT and BDNF increased (P < 0.01), and the serum IL-6 level decreased in both groups (P < 0.05 or P < 0.01), the serum CORT level reduced in the DXP group (P < 0.01), while the serum NE level elevated in the control group (P < 0.01). CONCLUSION: DXP is effective in improving symptoms of depression by regulating the levels of 5-HT, BDNF, CORT and IL-6.

PMID: 17432674 [PubMed - indexed for MEDLINE]

Lifestyle counseling in primary care: opportunities and challenges for changing practice.

Med Teach. 2008;30(2):185-191

Authors: Sargeant J, Valli M, Ferrier S, Macleod H

Background: Many patients today have health concerns related to lifestyle factors. This has created a situation where physicians are regularly confronted with the challenge of how to conduct lifestyle counseling with patients. Specific strategies can enable physicians to more effectively navigate this complex area of communication with patients, improving patient response in adopting healthy behaviours and increasing physician satisfaction with this task. Aim: To evaluate the impact of a lifestyle counseling workshop incorporating the motivational enhancement and transtheoretical models upon primary care clinicians' counseling practice patterns, especially communication and counseling skills, and attitudes toward lifestyle counseling. Method: This study used a mixed method research design. Forty-three clinicians completed a post-workshop evaluation and identified intended changes to practice following the workshop. Twelve participated in interviews several months later to explore the kinds of changes made and influences upon them. Results: Forty-one (95.3%) questionnaire respondents reported an intention to change their practice. Main changes reported were: asking more questions, listening more, assessing patients' readiness to change, tailoring counseling to patients' readiness to change. They seemed to have acquired and retained new knowledge and most were able to apply the new skills in their practices. Many reported feeling more comfortable and/or confident when interacting with patients in need of lifestyle change. But, time constraints, comfort with current skills, lack of self-efficacy, and fears of missing opportunities to influence patients, moderated participants' ability to adopt and maintain new approaches. Conclusions: While primary care clinicians can successfully learn specific lifestyle counseling skills and incorporate them into their practice following a two-hour evidence-based workshop, individual, educational and system factors can interfere.

PMID: 18464145 [PubMed - as supplied by publisher]

[Alternative and complementary therapies in fibromyalgia syndrome.]

Schmerz. 2008 May 9;

Authors: Langhorst J, Häuser W, Irnich D, Speeck N, Felde E, Winkelmann A, Lucius H, Michalsen A, Musial F

INTRODUCTION: Interdisciplinary S3 level guidelines were devised in cooperation with 8 medical, 2 psychological and 2 patient support groups. Results were elaborated in a multilevel group process. METHODS: On the bases of the "Cochrane Library" (1993-2006), "Medline" (1980-2006), "PsychInfo" (2006) and "Scopus" (2006) controlled studies and meta-analyses of controlled studies were analyzed. RESULTS: Only few controlled studies were found supporting in part the effectiveness of CAM therapies in the treatment of fibromyalgia syndrome. Due to the lack of information on long term efficacy and cost-effectiveness, only limited recommendations for CAM therapies can be given. CONCLUSION: Within a multicomponent therapy setting, selective CAM therapies (acupuncture, vegetarian diet, homeopathy, Tai Chi, Qi Gong, music-oriented and body-oriented therapies) can be recommended for a limited period of time.

PMID: 18463899 [PubMed - as supplied by publisher]

Treating the climacteric symptoms in Indian women with an integrated approach to yoga therapy: a randomized control study.

Menopause. 2008 May 6;

Authors: Chattha R, Raghuram N, Venkatram P, Hongasandra NR

OBJECTIVE:: To study the effect of yoga on the climacteric symptoms, perceived stress, and personality in perimenopausal women. DESIGN:: One hundred twenty participants (ages 40-55 y) were randomly divided into two study arms, ie, yoga and control. The yoga group practiced an integrated approach to yoga therapy comprising surya namaskara (sun salutation) with 12 postures, pranayama (breathing practices), and avartan dhyan (cyclic meditation), whereas the control group practiced a set of simple physical exercises under supervision of trained teachers for 8 weeks (1 h daily, 5 days per week). The assessments were made by Greene Climacteric Scale, Perceived Stress Scale, and Eysenck's Personality Inventory before and after the intervention. RESULTS:: Of the three factors of the Greene Climacteric Scale, the Mann-Whitney test showed a significant difference between groups (P < 0.05) in the vasomotor symptoms, a marginally significant difference (P = 0.06) in psychological factors but not in the somatic component. Effect sizes were higher in the yoga group for all factors. There was a significantly greater degree of decrease in Perceived Stress Scale scores (P < 0.001, independent samples t test) in the yoga group compared with controls (between-group analysis) with a higher effect size in the yoga group (1.10) than the control (0.27). On the Eysenck's Personality Inventory, the decrease in neuroticism was greater (P < 0.05) in the yoga group (effect size = 0.43) than the control group (effect size = 0.21) with no change in extroversion in either the yoga or control group. CONCLUSIONS:: Eight weeks of an integrated approach to yoga therapy decreases climacteric symptoms, perceived stress, and neuroticism in perimenopausal women better than physical exercise.

PMID: 18463543 [PubMed - as supplied by publisher]

Pilot of 'Families for Health': community-based family intervention for obesity.

Arch Dis Child. 2008 May 7;

Authors: Robertson W, Friede T, Blissett J, Rudolf MC, Wallis MA, Stewart-Brown S

OBJECTIVE: To develop and evaluate 'Families for Health' - a new community based family intervention for childhood obesity. DESIGN: Programme development, pilot study and evaluation using intention-to-treat analysis. SETTING: Coventry, England PARTICIPANTS: 27 overweight or obese children aged 7-13 years (18 girls, 9 boys) and their parents, from 21 families. INTERVENTION: 'Families for Health' is a 12 week programme with parallel groups for parents and children, addressing parenting, lifestyle change and social & emotional development. MAIN OUTCOME MEASURES: Primary: change in baseline BMI z-score at end of programme (3 months) and 9 month follow-up. Attendance, drop-out, parents' perception of programme, child's quality of life and self esteem, parental mental health, parent-child relationships and lifestyle changes were also measured. RESULTS: Attendance rate was 62%, with 18 of the 27 (67%) children completing the programme. For the 22 children with follow-up data (including 4 drop-outs), BMI z-score was reduced by -0.18 (95%CI -0.30 to -0.05) at end of programme and by -0.21 (-0.35 to -0.07) at 9 months. Statistically significant improvements were observed in children's quality of life and lifestyle (reduced sedentary behaviour, increased steps and reduced exposure to unhealthy foods), child-parent relationships and parents' mental health. Fruit and vegetable consumption, participation in moderate/vigorous exercise and children's self-esteem did not change significantly. Topics on parenting skills, activity and food were rated as helpful and were used with confidence by the majority of parents. CONCLUSIONS: Families for Health is a promising new childhood obesity intervention. Definitive evaluation of its clinical effectiveness by randomised controlled trial is now required.

PMID: 18463121 [PubMed - as supplied by publisher]

[Talking about "moxibustion treatment for before sick" from "ischemic preconditioning"]

Zhongguo Zhen Jiu. 2008 Mar;28(3):222-4

Authors: Hua JS, Sun ZR

"Treatment for before sick" is a theory of TCM, reflecting preventing thought of "prevention being better than cure" and "nipping in the bud", while "moxibustion treatment for before sick" is highly praised by doctors of past ages. Moxibustion can activate human vital-qi and increase immunologic function of the organism, playing a preventive role for before sick, which is similar to the essence of "ischemic preconditioning" raised in recent years. Because of convenient manipulation, no adverse effect, it has very important position in the field of preventive medicine.

PMID: 18447226 [PubMed - in process]

[Try to discuss manipulation of the "Feijing Zouqi" needling technique]

Zhongguo Zhen Jiu. 2008 Mar;28(3):202-4

Authors: Zhou D, Gao Y, Wang FC

Based on description of "Feijing Zouqi" needling methods in Jin Zhen Fu (Rhyme Prose of Golden Needle) written by Xu Feng, and explain and analyze the descriptions of "Feijing Zouqi" needling method in Zhenjiu Juying (A Collection of Gems in Acu-Moxibustion) written by Gao Wu, Zhenjiu Wendui written by Wang Ji, Zhenjiu Dacheng (Great Compendium on Acu-Moxibustion) written by Yang Ji-zhou, Yixue Rumen (Elementary Medicine) written by LI Chan and many other works, summarize the technique characteristics of all the "Feijing Zouqi" needling methods. The characteristic of "Qinglong Baiwei" needling method is " first toward the left, then toward the right, slowly move or adjust with the hand"; and "Baihu Yaotou" needling method emphasizes "Tuifang Jinyuan" and "Yaozhen "; key point of "Canggui Tanxue" needling method is "Zuanti Sifang"; Chifeng Yingyuan" needling method emphasizes "Siwei Feixuan".

PMID: 18447221 [PubMed - in process]

Reiki Improves Heart Rate Homeostasis in Laboratory Rats.

J Altern Complement Med. 2008 Apr 25;

Authors: Baldwin AL, Wagers C, Schwartz GE

ABSTRACT Objectives: To determine whether application of Reiki to noise-stressed rats can reduce their heart rates (HRs) and blood pressures. Rationale: In a previous study, we showed that exposure of rats to 90 dB white noise for 15 minutes caused their HRs and blood pressures to significantly increase. Reiki has been shown to significantly decrease HR and blood pressure in a small group of healthy human subjects. However, use of humans in such studies has the disadvantage that experimental interpretations are encumbered by the variable of belief or skepticism regarding Reiki. For that reason, noise-stressed rats were used as an animal model to test the efficacy of Reiki in reducing elevated HR and blood pressure. Design: Three unrestrained, male Sprague-Dawley rats implanted with radiotelemetric transducers were exposed daily for 8 days to a 15-minute white noise regimen (90 dB). For the last 5 days, the rats received 15 minutes of Reiki immediately before the noise and during the noise period. The experiment was repeated on the same animals but using sham Reiki. Setting/location: The animals were housed in a quiet room in University of Arizona Animal Facility. Outcome measures: Mean HRs and blood pressure were determined before Reiki/sham Reiki, during Reiki/sham Reiki, and during the noise in each case. Results: Reiki, but not sham Reiki, significantly reduced HR compared to initial values. With Reiki, there was a high correlation between change in HR and initial HR, suggesting a homeostatic effect. Reiki, but not sham Reiki, significantly reduced the rise in HR produced by exposure of the rats to loud noise. Neither Reiki nor sham Reiki significantly affected blood pressure. Conclusion: Reiki is effective in modulating HR in stressed and unstressed rats, supporting its use as a stress-reducer in humans.

PMID: 18435597 [PubMed - as supplied by publisher]

Interventions for alleviating cancer-related dyspnea: a systematic review.

J Clin Oncol. 2008 May 10;26(14):2396-404

Authors: Ben-Aharon I, Gafter-Gvili A, Paul M, Leibovici L, Stemmer SM

PURPOSE: Dyspnea is one of the most distressing symptoms experienced by terminally ill cancer patients. This study aimed to evaluate the role of interventions for the palliation of dyspnea. METHODS: We conducted a systematic review of randomized controlled trials assessing all pharmacologic and nonpharmacologic interventions for dyspnea palliation in cancer patients, and searched the Cochrane Library, MEDLINE, conference proceedings, and references. Two reviewers independently appraised the quality of trials and extracted data. RESULTS: Our search yielded 18 trials. Fourteen evaluated pharmacologic interventions: seven assessing opioids (a total of 256 patients), five assessing oxygen (137 patients), one assessing helium-enriched air, and one assessing furosemide. Four trials evaluated nonpharmacologic interventions (403 patients). The administration of subcutaneous morphine resulted in a significant reduction in dyspnea Visual Analog Scale (VAS) compared with placebo. No difference was observed in dyspnea VAS score when nebulized morphine was compared with subcutaneous morphine, although patients preferred the nebulized route. The addition of benzodiazepines to morphine was significantly more effective than morphine alone, without additional adverse effects. Oxygen was not superior to air for alleviating dyspnea, except for patients with hypoxemia. Nursing-led interventions improved breathlessness. Acupuncture was not beneficial. CONCLUSION: Our review supports the use of opioids for dyspnea relief in cancer patients. The use of supplemental oxygen to alleviate dyspnea can be recommended only in patients with hypoxemia. Nursing-led nonpharmacologic interventions seem valuable. Only a few studies addressing this question were performed. Thus, further studies evaluating interventions for alleviating dyspnea are warranted.

PMID: 18467732 [PubMed - in process]