BACKGROUND:This systematic review and meta-analysis is an update to prior research to evaluate the effects of yoga for managing prehypertension and hypertension. METHODS:Medline/PubMed, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from their inception until April 5th 2024. Randomized-controlled trials (RCTs) that compared yoga to any control intervention in participants with diagnosed prehypertension (120-139/80-89 mmHg) or hypertension (≥140/ ≥ 90mmHg) were included. Mean differences (MD) and 95% confidence intervals (CI) were calculated. Risk of Bias was assessed using the Cochrane tool. RESULTS:30 RCTs with 2283 participants were included. Very low quality of evidence was found for positive effects of yoga on systolic blood pressure (SBP, 26 RCTs, n = 2007; MD = -7.95 mmHg, 95% CI = -10.24 to -5.66, p < 0.01), diastolic blood pressure (DBP, 23 RCTs, n = 1836; MD = -4.93 mmHg, 95% CI = -6.25 to -3.60, p < 0.01) and heart rate (HR, 14 RCTs, n = 1118; MD = -4.43 mmHg, 95% CI = -7.36 to -1.50, p < 0.01) compared to waitlist control. Compared to active control, very low quality of evidence was found for positive effects yoga on SBP (5 RCTs, n = 306; MD = -4.16 mmHg, 95%CI = -10.76 to 2.44, p = 0.22), DBP (5 RCTs, n = 306; MD = -1.88 mmHg, 95%CI = -3.41 to -0.36, p = 0.02) and HR (2 RCT, n = 128; MD = -5.16 mmHg, 95% CI = -8.39 to -1.92, p < 0.01). Overall, the studies showed a high degree of heterogeneity. The effects found were robust against selection, detection and attrition bias. CONCLUSION:Yoga may be an option for lowering blood pressure in people with prehypertension to hypertension. More and larger high-quality studies are needed to substantiate our findings.

The global food system is responsible for climate change, biodiversity loss, and land-use changes. At the same time, the prevalence of diet-related, chronic diseases is increasing worldwide. A dietary shift to a plant-based diet could protect both planetary and individual health. Nudging can positively influence dietary choices. We investigated how different nudges influenced inpatients’ choices of plant-based menus. A quasi-experimental study was conducted across three consecutive four-week phases at the University Hospital Essen, Germany. In the baseline phase, inpatients chose meals from a standard menu without any intervention. In a second phase, an order nudge was applied by listing the plant-based dish first on the menu. In the third phase, a combined nudge was applied, adding a verbal recommendation to the order nudge. Data from 6,575 inpatients (mean age: 57.3 ± 18.7; 50.6

In der noch jungen Geschichte der Ohrakupunktur (Aurikulotherapie), die in den 1950er-Jahren mit der Ohrkartografie von Dr. Nogier ihren Anfang nahm, sind verschiedene Ohrakupunkturprotokolle entstanden. In den USA wurden das NADA-Protokoll (National Acupuncture Detoxification Association) und die BFA (Battlefield Acupuncture) entwickelt. Neben diesen internationalen Entwicklungen gibt es auch deutsche Entwicklungen wie die Balancierte Ohrakupunktur nach Seeber® (Yase-Institut, Lehrinstitut für Ohrakupunktur, Oldenburg, Leitung: Jan Seebe). Für die jeweiligen Protokolle werden unterschiedliche Einsatzgebiete mit verschiedenen Stärken und Schwächen beschrieben. Nach mehr als 10 Jahren klinischer Anwendung und Erfahrung dieser Protokolle in der Abteilung für Naturheilkunde und Integrative Medizin, Evang. Kliniken Essen-Mitte, einem akademischen Lehrkrankenhaus der Universität Duisburg-Essen, Deutschland, haben wir eine neue Methode namens RAVA, Regulative und vitalisierende (Ohr‑)Akupunktur, entwickelt. RAVA kombiniert die 3 Basispunkte zur Regulation des dreifachen Erwärmers (3E) mit 2 individuellen Ohrakupunkturpunkten. Durch die ursächliche Therapie des 3E (d. h. die Wirkung auf den Qi-Fluss und die Organfunktion) und den symptomatischen Ansatz verfügt die RAVA-Methode über ein breites, vielseitig einsetzbares, aber im Einzelfall hochgradig individualisierbares Wirkspektrum.

Ramadan fasting has seen increased attention in research, often with inconsistent findings. This study aims to investigate whether dietary and lifestyle modifications during Ramadan can improve well-being and health in healthy adult Muslims. A randomised controlled trial with two parallel groups was conducted in an outpatient clinic of a university hospital in Essen, Germany, in 2016. Healthy adult Muslims (n = 114) aged 18–60 years were randomised to a modified fasting group; i.e., they received educational material prompting dietary and lifestyle modifications pre-Ramadan, and a control group who undertook Ramadan fasting as usual. Primary outcome was quality of life (WHO-5 Well-Being Index). Secondary outcomes included sleep quality, spirituality, and mindfulness (all self-report), body weight, body mass index, body fat, waist circumference, hip circumference, blood pressure, and heart rate, as well as blood serum biomarkers. Safety was examined via adverse events. The modified fasting group reported significantly higher quality of life (WHO-5) compared to the control after Ramadan (MD 5.9; 95 ClinicalTrials.gov (Identifier NCT02775175).

Objectives: Neck reflex points or Adler-Langer Points are commonly used in neural therapy to detect so-called interference fields. The individual treatment strategy is based on the results of diagnostic Adler-Langer Points palpation. This study investigated the inter- and intra-rater reliability and explored treatment effects. Design, Settings/Location, Subjects: We performed a randomized-controlled trial with 104 inpatients of a German department for internal and integrative medicine. Intervention: Patients were randomized to individual neural therapy according to the pathological findings (n=48) or no treatment (n=56). Outcome measures: In each patient, three experienced raters (20-45y experience in neural therapy) and two novice raters (medical students) rated Adler-Langer Points rigidity on a standardized rating scale. Pressure pain thresholds were assessed at the eight Adler-Langer Points. All patients were retested after 30 minutes. The five raters were blinded to treatment allocation and assessments of the other raters. Video recordings were obtained to assess the consistency of the areas tested by the different raters. Results: Agreement between patients and raters and inter-rater reliability were low. Moreover, the individual agreement (pre-post comparisons in untreated patients) was similarly low even in experienced raters. Pressure pain thresholds at five of the eight Adler-Langer Points showed significant changes after treatment compared to none in the control group. Conclusion: Under this artificial experimental setting, this method of Adler-Langer Point palpation has not proven to be a reliable diagnostic tool. But it could be shown, that as claimed by the method, the tenderness in five of eight Adler-Langer Points decreased after neural therapy.

Lifestyle interventions can have a positive impact on quality of life and psychological parameters in patients with metabolic syndrome (MetS). In this randomized controlled trial, 145 participants with MetS (62.8% women; 59.7 ± 9.3 years) were randomized to (1) 5-day fasting followed by 10 weeks of lifestyle modification (F + LM; modified DASH diet, exercise, mindfulness; n = 73) or (2) 10 weeks of lifestyle modification only (LM; n = 72). Outcomes were assessed at weeks 0, 1, 12, and 24, and included quality of life (Short-Form 36 Health Survey Questionnaire, SF-36), anxiety/depression (Hospital Anxiety and Depression Scale, HADS), stress (Cohen Perceived Stress Scale, CPSS), mood (Profile of Mood States, POMS), self-efficacy (General Self-Efficacy Scale, GSE), mindfulness (Mindfulness Attention Awareness Scale, MAAS), and self-compassion (Self-Compassion Scale, SCS). At week 1, POMS depression and fatigue scores were significantly lower in F + LM compared to LM. At week 12, most self-report outcomes improved in both groups—only POMS vigor was significantly higher in F + LM than in LM. Most of the beneficial effects within the groups persisted at week 24. Fasting can induce mood-modulating effects in the short term. LM induced several positive effects on quality of life and psychological parameters in patients with MetS.

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).

Objectives: To systematically review and meta-analyze the effectiveness of yoga for low back pain. Methods: MEDLINE, the Cochrane Library, EMBASE, CAMBASE, and PsycINFO, were screened through January 2012. Randomized controlled trials comparing yoga to control conditions in patients with low back pain were included. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Main outcome measures were pain, back-specific disability, generic disability, health-related quality of life, and global improvement. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Results: Ten randomized controlled trials with a total of 967 chronic low back pain patients were included. Eight studies had low risk of bias. There was strong evidence for short-term effects on pain (SMD=−0.48; 95% CI, −0.65 to −0.31; P<0.01), back-specific disability (SMD=−0.59; 95% CI, −0.87 to −0.30; P<0.01), and global improvement (risk ratio=3.27; 95% CI, 1.89-5.66; P<0.01). There was strong evidence for a long-term effect on pain (SMD=−0.33; 95% CI, −0.59 to −0.07; P=0.01) and moderate evidence for a long-term effect on back-specific disability (SMD=−0.35; 95% CI, −0.55 to −0.15; P<0.01). There was no evidence for either short-term or long-term effects on health-related quality of life. Yoga was not associated with serious adverse events. Discussion: This systematic review found strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low back pain in the most important patient-centered outcomes. Yoga can be recommended as an additional therapy to chronic low back pain patients.

Background: Lifestyle interventions, such as fasting, diet, and exercise, are increasingly used as a treatment option for patients with metabolic syndrome (MS). This study assesses the efficacy and safety of fasting followed by lifestyle modification in patients with MS compared to lifestyle modification only. Methods: Single-blind, multicenter, parallel, randomized controlled trial in two German tertiary referral hospitals in metropolitan areas. Interventions: (a) 5-day fasting followed by 10 weeks of lifestyle modification (modified DASH diet, exercise, mindfulness; n = 73); (b) 10 weeks of lifestyle modification only (n = 72). Main outcomes and measures: Co-primary outcomes were ambulatory systolic blood pressure and the homeostasis model assessment (HOMA) index at week 12. Further outcomes included anthropometric, laboratory parameters, and the PROCAM score at weeks 1, 12, and 24. Results: A total of 145 patients with metabolic syndrome (62.8% women; 59.7 ± 9.3 years) were included. No significant group differences occurred for the co-primary outcomes at week 12. However, compared to lifestyle modification only, fasting significantly reduced HOMA index (Δ = −0.8; 95% confidence interval [CI] = −1.7, −0.1), diastolic blood pressure (Δ = −4.8; 95% CI = −5.5, −4.1), BMI (Δ = −1.7; 95% CI = −2.0, −1.4), weight (Δ = −1.7; 95% CI = −2.0, −1.4), waist circumference (Δ = −2.6; 95% CI = −5.0, −0.2), glucose (Δ = −10.3; 95% CI = −19.0, −1.6), insulin (Δ = −2.9; 95% CI = −5.3, −0.4), HbA1c (Δ = −0.2; 95% CI = −0.4, −0.05;), triglycerides (Δ = −48.9; 95% CI = −81.0, −16.9), IL−6 (Δ = −1.2; 95% CI = −2.5, −0.005), and the 10-year risk of acute coronary events (Δ = −4.9; 95% CI = −9.5, −0.4) after week 1. Fasting increased uric acid levels (Δ = 1.0; 95% CI = 0.1, 1.9) and slightly reduced eGRF (Δ = −11.9; 95% CI = −21.8, −2.0). Group differences at week 24 were found for weight (Δ = −2, 7; 95% CI = −4.8, −0.5), BMI (Δ = −1.0; 95% CI = −1.8, −0.3), glucose (Δ = −7.7; 95% CI = −13.5, −1.8), HDL (Δ = 5.1; 95% CI = 1.5, 8.8), and CRP (Δ = 0.2; 95% CI = 0.03, 0.4). No serious adverse events occurred. Conclusions: A beneficial effect at week 24 was found on weight; fasting also induced various positive short-term effects in patients with MS. Fasting can thus be considered a treatment for initializing lifestyle modification for this patient group; however, it remains to be investigated whether and how the multilayered effects of fasting can be maintained in the medium and longer term.

Background Acupuncture is frequently used to treat the side effects of cancer treatment, but the safety of this intervention remains uncertain. The current meta‐analysis was conducted to assess the safety of acupuncture in oncological patients. Methods The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched from their inception to August 7, 2020. Randomized controlled trials in oncological patients comparing invasive acupuncture with sham acupuncture, treatment as usual (TAU), or any other active control were eligible. Two reviewers independently extracted data on study characteristics and adverse events (AEs). Risk of bias was assessed using the Cochrane Risk of Bias Tool. Results Of 4590 screened articles, 65 were included in the analyses. The authors observed that acupuncture was not associated an with increased risk of intervention‐related AEs, nonserious AEs, serious AEs, or dropout because of AEs compared with sham acupuncture and an active control. Compared with TAU, acupuncture was not associated with an increased risk of intervention‐related AEs, serious AEs, or drop out because of AEs but was associated with an increased risk for nonserious AEs (odds ratio, 3.94; 95% confidence interval, 1.16‐13.35; P = .03). However, the increased risk of nonserious AEs compared with TAU was not robust against selection bias. The meta‐analyses may have been biased because of the insufficient reporting of AEs in the original randomized controlled trials. Conclusions The current review indicates that acupuncture is as safe as sham acupuncture and active controls in oncological patients. The authors recommend researchers heed the CONSORT (Consolidated Standards of Reporting Trials) safety and harm extension for reporting to capture the side effects and better investigate the risk profile of acupuncture in oncology. Lay Summary According to this analysis, acupuncture is a safe therapy for the treatment of patients with cancer. Acupuncture seems to be safe compared with sham acupuncture and active controls.

Arterial hypertension is a major public health issue. Non-pharmacological approaches like Mindfulness-Based Stress Reduction (MBSR) might be a promising addition to conventional therapy. This systematic review and meta-analysis aim to evaluate the effects of MBSR on systolic (SBP) and diastolic blood pressure (DBP) among individuals with prehypertension or hypertension. We searched Medline/PubMed, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) from their inception until August 1st 2021. RCTs were included that compared MBSR to any control intervention in participants with diagnosed prehypertension (120–139/80–89 mmHg) or hypertension (≥140/≥90 mmHg). Mean differences (MD) and 95% confidence intervals (CI) were calculated. Risk of Bias was assessed using the Cochrane tool. Seven RCTs with 429 participants were included. Very low quality of evidence was found for positive effects of MBSR on SBP (MD = −11.26 mmHg, 95%CI = −20.24 to −2.29, p = 0.01) but no evidence for effects on DBP levels (MD = −3.62 mmHg, 95%CI = −8.52 to 1.29, p = 0.15) compared to waitlist control. Compared to active control, very low quality of evidence was found for positive effects on DBP (MD = −5.51 mmHg, 95%CI = −10.93 to −0.09, p = 0.05) but no effects on SBP levels (MD = −4.33 mmHg, 95%CI = −12.04 to 3.38, p = 0.27). Overall, the studies showed a high degree of heterogeneity. The effects found were robust against selection, detection, and attrition bias. Only one RCT reported safety data. MBSR may be an option for lowering blood pressure in people with prehypertension to hypertension. More and larger high-quality studies are needed to substantiate our findings.

Background Therapies from traditional Chinese medicine (TCM) are increasingly being integrated into western treatment concepts within the framework of integrative oncology. The focus is on reducing side effects caused by oncological treatment, improving the quality of life and promoting a healthy lifestyle. The aim is not to achieve a cure but to strengthen and harmonize the patient. The TCM can therefore be a useful supplement to conventional treatment. Objective This article gives a brief survey of the state of evidence as well as the fields of application of TCM in integrative oncology. Results There is good evidence for acupuncture and acupressure especially for pain: chemotherapy-induced polyneuropathy (CIPN) aromatase inhibitor (AI)-induced arthralgia and cancer-related pain. There are also positive data on the improvement of nausea, sleep disorders, hot flashes and cognitive impairments with acupuncture/acupressure; however, more recent data on improving fatigue and global quality of life are not entirely conclusive. Taking TCM herbs is not recommended from a scientific point of view, only ginseng for fatigue and ginger against chemotherapy-induced nausea and vomiting (CINV) can be tried. Conclusion There is good evidence for a number of TCM procedures, especially for acupuncture/acupressure for pain relief (caused by chemotherapy, aromatase inhibitors or the cancer itself). Sleep, cognition and menopausal symptoms can also be improved by acupuncture/acupressure. As a single drug, ginseng can be tried against fatigue and ginger against nausea.

This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).

Abstract Background Cancer registries usually assess data of conventional treatments and/or patient survival. Beyond that, little is known about the influence of other predictors of treatment response related to the use of complementary therapies (CM) and lifestyle factors affecting patients’ quality and quantity of life. Methods INTREST is a prospective cohort study collecting register data at multiple German certified cancer centers, which provide individualized, integrative, in- and outpatient breast cancer care. Patient-reported outcomes and clinical cancer data of anticipated N = 715 women with pTNM stage I-III breast cancer are collected using standardized case report forms at the time of diagnosis, after completing neo−/adjuvant chemotherapy, after completing adjuvant therapy (with the exception of endocrine therapy) as well as 1, 2, 5, and 10 years after baseline. Endpoints for multivariable prediction models are quality of life, fatigue, treatment adherence, and progression-based outcomes/survival. Predictors include the study center, sociodemographic characteristics, histologic cancer and comorbidity data, performance status, stress perception, depression, anxiety, sleep quality, spirituality, social support, physical activity, diet behavior, type of conventional treatments, use of and belief in CM treatments, and participation in a clinical trial. Safety is recorded following the Common Terminology Criteria for Adverse Events. Discussion This trial is currently recruiting participants. Future analyses will allow to identify predictors of short- and long-term response to integrative breast cancer treatment in women, which, in turn, may improve cancer care as well as quality and quantity of life with cancer. Trial registration German Clinical Trial Register DRKS00014852 . Retrospectively registered at July 4th, 2018.

ZusammenfassungBis zu drei Viertel der onkologischen Patientinnen in Deutschland wenden komplementäre Therapien an. Das Kap. „Integrative Onkologie bei gynäkoonkologischen Tumoren“ gibt einen Überblick über evidenzbasierte und praxisorientierte Empfehlungen zu komplementärmedizinischen Therapien in der gynäkologischen Onkologie. Ein Wirksamkeitsnachweis mit einer Grad-A-Evidenz besteht zur Verbesserung der Lebensqualität und depressiver Symptome für Meditation, Entspannungstraining und Mindfulness-Based Stress Reduction (MBSR) und zur Reduktion von Angst für Meditation. Yoga empfiehlt sich zur Linderung von Angst, Depression und bei eingeschränkter Lebensqualität (Grad-B-Evidenz), Massagen und Musiktherapie wirken ebenfalls antidepressiv (Grad-B-Evidenz). Durch Akupressur kann die Chemotherapie-induzierte Übelkeit vermindert werden (Grad-B-Evidenz). Zur Linderung von Hitzewallungen und Gelenkschmerzen unter antihormoneller Therapie wird Akupunktur eingesetzt (Grad-C-Evidenz). Kurzzeitfasten unter Chemotherapie scheint machbar, laufende Studien werden klären, ob ein Nutzen durch die Intervention zu erwarten ist. Auch wird zunehmend über die Auswirkungen von Schlafstörungen und wirksame Therapien geforscht.

BACKGROUND:In Germany, there is hardly any institutionalization of pediatric complementary and integrative medicine (CIM) present, which is one reason why the statutory health insurance companies usually do not cover the costs. Which in turn serves as an obstacle for integrating CIM into routine pediatric care. Within the present study, we assessed existing demand for CIM methods in parents of children in clinical primary care and whether the parents would be willing to cover the costs privately.METHODS:Parents who visited the Pediatric Department of the Elisabeth Hospital, Essen, Germany and the Children's Hospital St. Marien, Landshut, Germany with their children in 2015 and 2016 were asked to take part in a paper-pencil survey. Both outpatients and inpatients were interviewed.RESULTS:1323 parents took part in the survey. 40 % of them stated that they already use CIM for their children. Homeopathy was the most frequently mentioned with almost 60 %, followed by osteopathy and phytotherapy. More than 80 % of the participants endorsed the expansion of the CIM offers in respective hospitals. Homeopathy was the method most desired by the parents, followed by osteopathy, phytotherapy and massage therapies. The majority (88 %) of the parents stated that they would like to take advantage of an extended range of services, including extra services that they would have to pay privately for.CONCLUSION:Many parents are already using CIM for their children and are looking forward to CIM being incorporated in clinical primary care. They would also be willing to bear the costs themselves if the therapy in question is not covered by their insurance. pay for the costs themselves if the therapy is not covered by their insurance.

Zusammenfassung Hintergrund Pflanzliche Arzneimittel finden in Deutschland traditionell sehr häufig Anwendung. Ihre Nutzung beruht auf einem jahrhundertelangen Erfahrungsschatz. Historische Quellen werden jedoch bei der wissenschaftlichen Untersuchung pflanzlicher Arzneimittel häufig außer Acht gelassen. Das Ziel der vorliegenden narrativen Übersichtsarbeit ist es, am Beispiel der Arzneipflanze Rhodiola rosea (Rosenwurz) einen umfassenden Überblick über den integrierten Forschungsstand zu dieser Pflanze zu liefern. Hierfür wurde historische Literatur zur traditionellen Nutzung von R. rosea sowohl aus naturwissenschaftlicher als auch aus geschichtswissenschaftlicher Perspektive analysiert und in einer beschreibenden Zusammenfassung dargestellt. Zusammenfassung Insgesamt wurden 15 historische Quellen mit Informationen zur traditionellen Nutzung von Rosenwurz identifiziert. Die historische Quellenlage ist allerdings als sehr überschaubar einzuschätzen. Die erste Erfassung von R. rosea zur medizinischen Verwendung geht zurück auf Dioskurides in der Antike. Viele der zeitlich nachfolgenden Quellen beziehen sich bei ihrer Beschreibung von Rosenwurz direkt auf die Darstellungen des Dioskurides. Alle gefundenen Quellen zu Rosenwurz beschreiben eine Anwendung bei Kopfschmerzen. Darüber hinaus wird eine Anwendung bei Geschwülsten, Periodenbeschwerden, Leberleiden, „Wassersucht“, „Hysterie“ sowie eine nervenstärkende Wirkung beschrieben, welche sich durchaus in modernen Studienergebnissen wiederfinden lässt. Die heutige medizinische Nutzung von R. rosea als Adaptogen mit stressprotektiver Wirkung wird in der Form jedoch nicht in den historischen Quellen beschrieben. Im Gegensatz zur heutigen Anwendung in Form von Kapseln, Tabletten oder Tropfen erfolgte die traditionelle Anwendung hauptsächlich äußerlich in Form von Salben, Pasten oder Wickeln. Zu konkreten Anwendungsmodalitäten lassen sich nur wenige bis keine Informationen aus den vorliegenden Quellen gewinnen. Eine weiterführende systematische Recherche von historischen Quellen Nord- und Osteuropas stellt aufgrund des Vorkommens der Pflanze in überwiegend zirkumpolaren und alpinen Regionen möglicherweise eine wertvolle Ressource für zusätzliche Informationen dar. Kernaussage Historische Quellen zu traditionellen medizinischen Verfahren stellen eine wichtige Informationsquelle für die heutige Wissenschaft dar, welche dazu beitragen können, die heutige, gut etablierte medizinische Anwendung zu untermauern und darüber hinaus wertvolle Ansatzpunkte für neue Forschungsrichtungen bieten.

Objective: The present study presents long-term results of stress-related outcomes of a prospective RCT that evaluated effects of a ten-week comprehensive lifestyle-modification program (LSM) in patients with inactive ulcerative colitis (UC). In addition, exploratory results of a sub-study applying a laboratory stress protocol (Trier Social Stress Test; TSST) conducted within the RCT are reported. Methods: Ninety-seven patients with inactive UC were randomized to LSM (n = 47; 50.28 ± 11.90 years; 72.3% female) or self-care (n = 50; 45.54 ± 12.49 years; 70% female). Patients’ perceived stress, anxiety, flourishing and depression were assessed at week 0, 12, 24 and 48. After the respective intervention, 16 female patients (LSM: n = 8; 44.6 ± 14.3 years; Self-care: n = 8; 49.25 ± 4.30 years) additionally underwent the TSST. State anxiety, blood pressure, pulse, complete blood counts, adrenocorticotropic hormone (ACTH), cortisol, adrenalin and noradrenalin were measured at baseline (−15 min), stress (+10 min), recovery1 (+20 min) and recovery2 (+55 min). Statistical significance was set at p < 0.05; for the exploratory sub-study using the TSST, p-values < 0.10 were considered significant. Results: Patients’ perceived stress declined significantly after the LSM (p < 0.001) compared with control. This lasted until week 24 (p = 0.023) but did not persist until week 48 (p = 0.060). After 48 weeks, patients’ flourishing was significantly increased compared with control (p = 0.006). In response to the TSST, significant group differences were evident for pulse (p = 0.015), adrenaline (p = 0.037) and anxiety (p = 0.066). After 55 min, group differences were found for ACTH (p = 0.067) and systolic blood pressure (p = 0.050). Conclusions: LSM has a medium-term positive effect on perceived stress. First indications show that it is promising to investigate these effects further under laboratory conditions. It is also desirable to find out how the effects of LSM can be maintained in the long term.

Background Diagnosis, treatment and survival of cancer are associated with a complex set of stress factors. To promote emotional and physical well-being and also reduce psychological stress, mind-body therapies are often used in integrative cancer treatment. Objectives A survey of the state of evidence and fields of application of mind-body medicine in integrative oncology are presented. Results During and after completion of primary therapy, mindfulness-based stress reduction (MBSR) shows positive effects on anxiety, stress, fatigue, and menopausal symptoms, while quality of sleep and cognitive performance are increased. The effects of yoga, especially on fatigue in patients with breast cancer during and after completion of primary therapy, have been well documented. Yoga also improves sleep disorders and menopausal symptoms. Hypnosis reduces pain, psychological stress, nausea/vomiting and fatigue perioperatively, under radiotherapy and in advanced stages of the disease. Relaxation techniques and meditation primarily reduce stress, while multimodal services combining various evidence-based concepts of mind-body therapies can improve quality of life on many levels. Conclusions There is broad evidence for the safety and efficacy of MBSR in improving treatment-related symptoms and reducing psychological stress. Yoga helps alleviate fatigue and menopausal symptoms, while improving sleep and cognitive performance. Furthermore, relaxation training and meditation reduce depression and improve stress management, and hypnosis reduces pain and mental stress.

Eine große Zahl onkologischer Patientinnen in Deutschland wendet komplementäre Therapien an. Dieser Beitrag gibt einen Überblick über evidenzbasierte und praxisorientierte Empfehlungen zu komplementärmedizinischen Therapien in der gynäkologischen Onkologie.