还原型谷胱甘肽对糖尿病大鼠肾小球内皮功能的影响

目的:观察早期糖尿病肾病(diabetic nephropathy,DN)大鼠肾小球内皮功能的特点,探讨还原型谷胱甘肽对早期DN大鼠内皮功能的影响。方法:将大鼠分为对照组、模型组和治疗组,应用链脲佐菌素腹腔注射建立DN模型,治疗组每天腹腔注射还原型谷胱甘肽。应用相关试剂盒检测尿白蛋白(UA)、肾小球组织一氧化氮(NO)、内皮型一氧化氮合酶(eNOS)活性、血管性假性血友病因子(vWF)和超氧化物歧化酶、丙二醛(MDA)、谷胱甘肽过氧化物酶。结果:与对照组比较,模型组早期DN大鼠肾小球NO含量、eNOS活性均显著下降,vWF水平明显升高,UA显著增加(P<0.01),且UA增加的程度与vWF升高的水平呈正相关关系(P<0.05);肾小球组织中超氧化物歧化酶、谷胱甘肽过氧化物酶均明显下降,MDA明显升高(P<0.01)。与模型组比较,治疗组大鼠肾小球NO含量、eNOS活性均明显上升,vWF水平显著降低,UA明显减少,肾小球组织中MDA显著下降(P<0.01)。结论:早期DN大鼠肾小球内皮功能紊乱,氧化应激水平明显升高,还原型谷胱甘肽可能通过降低早期DN大鼠肾小球内氧化应激水平从而改善肾小球内皮功能。     

羟苯磺酸钙联合阿魏酸哌嗪治疗早期糖尿病肾病的临床研究

目的:观察羟苯磺酸钙联合阿魏酸哌嗪治疗早期糖尿病肾病(DN)的疗效并探讨其作用机制。方法:将我科收治的85例早期DN患者随机分为治疗组和对照组,对照组常规降糖治疗,治疗组常规降糖加用羟苯磺酸钙片500 mg,1 d 3次,阿魏酸哌嗪片200 mg,1日3次,疗程6个月。观察治疗前后尿白蛋白排出量(UAE)、空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbA1C)、肝肾功能、凝血功能、血脂、血栓烷素B2(TXB2)及高敏C反应蛋白(hs-CRP)变化。结果:治疗后3个月,治疗组UAE开始下降(P<0.05),对照组无明显下降(P>0.05);治疗后6个月,治疗组纤维蛋白原(FIB)、低密度脂蛋白胆固醇(LDL-C)、TXB2、hs-CRP均明显下降(P<0.01),FBG、PBG、HbA1C、肝肾功能差异无统计学意义;对照组治疗前后各项指标无明显改变(P>0.05)。结论:羟苯磺酸钙联合阿魏酸哌嗪能减轻早期DN尿白蛋白排泄,部分逆转DN进展,其通过降低FIB、LDL-C、TXB2、hs-CRP等改善高凝、微炎症状而实现肾脏保护作用。     

羟苯磺酸钙治疗早期糖尿病肾病的疗效观察

目的观察羟苯磺酸钙治疗早期糖尿病肾病的临床疗效。方法早期糖尿病肾病患者42例，随机分成两组：对照组，21例，常规降糖治疗；治疗组，21例，常规降糖加用羟苯磺酸钙500mg tid治疗，疗程12周。观察治疗前后24h尿白蛋白排出量（UAE）、血浆内皮素（ET）、血清一氧化氮（NO）、空腹血糖、餐后2h血糖、糖化血红蛋白、肝肾功能的变化。结果 治疗组治疗后，UAE显著降低（P＜0.01)，ET降低，NO升高；空腹血糖、餐后2h血糖、糖化血红蛋白、肝肾功能差异无统计学意义。对照组治疗后，UAE、ET、NO、空腹血糖、糖化血红蛋白、肝肾功能差异无统计学意义。结论羟苯磺酸钙能减少早期糖尿病肾病患者的尿白蛋白排泄，延缓糖尿病肾病的进展；并通过降低血浆ET、增加血清NO以实现对肾脏的保护作用。     

黄芪消渴方联合前列地尔治疗气阴两虚型糖尿病肾病的疗效及对血管内皮、氧化应激的影响

目的:观察黄芪消渴方联合前列地尔对气阴两虚型糖尿病肾病(DN)的临床疗效及对血管内皮、氧化应激的影响。方法:选取在本院糖尿病专科病房及门诊就诊的气阴两虚型DN患者72例为研究对象,随机分为对照组与观察组,每组36例。两组均予降糖、降压、降脂、抗血小板聚集等常规治疗,对照组在常规治疗基础上给予前列地尔静推治疗,观察组在对照组基础上给予黄芪消渴方加减口服,两组均每日治疗一次,共观察4周。比较两组治疗前后的中医临床证候积分、临床疗效;空腹血糖(FPG)、糖化血红蛋白(HbA1C)、血脂(TC、TG、LDL、HDL)、血肌酐(SCr)、血尿素氮(BUN);内皮素-1(ET-1)、一氧化氮(nitric oxide,NO)、血管性血友病因子(vWF);谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)的水平。结果:观察组中医证候疗效总有效率高于对照组,差异具有统计学意义(P<0.05);观察组中医证候积分比对照组明显减少,差异具有统计学意义(P<0.05);与对照组比较,观察组HDL-C变化不大,差异无统计学意义(P>0.05);FBG、HbA1C、SCr、BUN、TC、TG、LDL-C、ET-1、vWF、MDA显著下降,NO、GSH-Px、SOD显著上升,差异具有统计学意义(P<0.05)。结论:黄芪消渴方联合前列地尔治疗气阴两虚型DN疗效显著,不仅能降低血糖,调节血脂,改善肾功能及中医临床症状,还能抑制机体氧化应激反应并保护血管内皮功能。     

益气温阳活血方联合西医常规治疗对早期糖尿病肾病微炎症状态及血管内皮功能的影响

目的 研究益气温阳活血方联合西医常规治疗对早期糖尿病肾病(DN)微炎症状态及血管内皮功能的影响。方法 将86例早期DN患者随机分为治疗组42例和对照组44例,对照组采用常规西医治疗,治疗组在对照组治疗方法的基础上联合益气温阳活血方,治疗时间为12周。分别在治疗前及治疗6周、12周时,检测炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)及血管内皮功能内皮依赖性血管舒张功能(FMD)、尿白蛋白排泄率(UAE)等,并进行统计比较。结果 组内比较:治疗组治疗6周和12周时IL-6,TNF-α,MCP-1,UAE均显著降低,与治疗前比较,差异均有统计意义(P0.05或P0.01);对照组治疗6周时IL-6,TNF-α,MCP-1,UAE均有所降低,但与治疗前比较差异无统计意义(P0.05),治疗12周时IL-6,TNF-α,MCP-1,UAE均显著降低,与治疗前比较,差异均有统计意义(P0.05);2组治疗后FMD均有所升高,但与同组治疗前比较差异均无统计意义(P0.05)。组间比较:治疗6周时,2组以上各项指标比较差异均无统计意义(P0.05);治疗12周时,2组IL-6,TNF-α,MCP-1,UAE比较差异均有统计意义(P0.05),FMD比较差异无统计意义(P0.05)。结论 益气温阳活血方联合西医常规治疗能够抑制早期DN患者血浆炎症因子TNF-α,IL-1,MCP-1的表达,改善体内微炎症状态;能够降低DN患者的UAE,减少对血管内皮功能的损伤,从而减轻肾小球硬化,起到保护肾脏、延缓肾脏病进展的作用。     

羟苯磺酸钙与培哚普利治疗Ⅲ期糖尿病肾病的疗效比较

目的比较羟苯磺酸钙和培哚普利对血压正常的Ⅲ期糖尿病肾病(DN)患者的疗效。方法将106例Ⅲ期DN患者随机分成3组,A组为对照组,常规降糖治疗;B组常规降糖治疗 羟苯磺酸钙500mg,3次/d;C组常规降糖治疗 培哚普利4mg,1次/d。观察12周。比较3组患者治疗前后24h尿清蛋白排泄率(UAE)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)、血压、血脂和肾功能的变化。结果治疗后第4、8、12周,A、B两组间及A、C两组间UAE差异有统计学意义(P<0.05),而B、C两组间UAE差异无统计学意义(P>0.05)。治疗12周后,B组TXB2及6-keto-PGF1α水平与治疗前比较,差别有统计学意义(P<0.05);B组与A组比较TXB2及6-keto-PGF1α水平间差别亦均有统计学意义(P<0.05),而A、C两组TXB2和6-keto-PGF1α水平间差别无统计学意义(P>0.05)。3组患者治疗前后血压、血脂和肾功能指标间差别均无统计学意义(P>0.05)。结论羟苯磺酸钙降低Ⅲ期DN患者UAE的疗效与培哚普利相似;且能降低血小板高活性,延缓DN进展。     

通心络胶囊对早期糖尿病肾病患者血管内皮功能及肾功能的影响

目的探讨通心络胶囊对早期糖尿病肾病(DN)患者血管内皮功能及肾功能的影响。方法选择2012年4月一2013年6月住院的DN患者100例,按照随机数字表法分为对照组和观察组各50例,2组患者均注射胰岛素降糖、他汀类降脂药及硫酸氢氯吡格雷等常规基础药物治疗,观察组在常规治疗基础上加服通心络胶囊。2组均治疗12周。观察治疗前后2组患者血管内皮功能及肾功能的变化。结果治疗前2组患者血管内皮功能及肾功能比较差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组患者血管内皮生长因子(VEGF)、一氧化氮(NO)均升高(t_对=1.878、1.934;t_观=1.971、1.952,P均<0.05),内皮素-1(ET-1)、血肌酐(SCr)、尿素氮(BUN)、肌酐清除率(CCr)、胱抑素-C(Cys-C)、肿瘤坏死因子-α(TNF-α)均降低(t_对=1.846、1.792、1.813、1.885、1.861、1.916;t_观=1.891、1.808、1.900、2.034、2.012、1.978,P均<0.05)。与对照组治疗后比较,观察组VEGF、NO、均明显升高(t=2.265、3.348,P均<0.05),ET-1、SCr、BUN、CCr、Cys-C、TNF-α均明显降低(t=2.461、2.267、2.166、2.413、2.201、2.332,P均<0.05)。结论通心络胶囊能明显改善DN患者肾功能、血管内皮功能,降低体内炎性因子水平。     

瑞舒伐他汀对代谢综合征患者血浆vWF及NO含量的影响

目的观察瑞舒伐他汀对代谢综合征(metabolic syndrome,MS)患者血浆中血管性假性血友病因子(von willebrand factor,vWF)和一氧化氮(nitric oxide,NO)含量的影响,探讨其对内皮功能的影响。方法 80例MS患者随机分为常规组和瑞舒伐他汀组,每组40例,同时选择健康体检者40例作为正常对照组。瑞舒伐他汀组在常规用药的基础上加服瑞舒伐他汀10 mg/d,治疗3个月。治疗前后分别检测血压、空腹血糖(fasting blood glu-cose,FBG)、空腹胰岛素(fasting insulin,FINS)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(HDL-C)、NO及vWF,超声检测内皮依赖性血流介导的血管舒张功能。结果治疗后常规组和瑞舒伐他汀组的血压、FBS、FINS及vWF水平明显下降(P<0.05),而NO水平明显升高(P<0.05),内皮依赖性血管舒张功能明显改善(P<0.05);同时治疗后MS两组相比亦差异显著,瑞舒伐他汀组改善内皮功能作用更强。结论瑞舒伐他汀可明显降低MS患者血浆vWF水平,并升高NO含量,更进一步改善血管内皮功能。     

通心络胶囊对不稳定型心绞痛患者血管内皮功能的影响

目的 探讨通心络胶囊对不稳定型心绞痛(UAP)患者血管内皮功能的影响.方法 100例UAP患者,随机分为常规组(西医常规治疗)和通心络组(西医常规加通心络治疗),观察治疗前和治疗1个月后血清内皮素(ET)、一氧化氮(NO)、血管性假血友病因子(vWF)、可溶性血管细胞粘附分子-1(sVCAM-1)、可溶性细胞间粘附分子-1(sVCAM-1)的变化,并应用多普勒超声诊断仪测定肱动脉血流介导的血管扩张变化率(FMD).结果 与治疗前比较,治疗后两组患者血清vWF、ET水平均明显下降(P<0.01),NO水平和FMD 均升高(P<0.05或P<0.01);通心络组血清sVCAM-1水平显著下降(P<0.01),而常规组血清sVCAM-1水平无明显变化(P>0.05).治疗后通心络组血清vWF、ET、sVCAM-1水平均低于常规组(P<0.01),NO水平和FMD 高于常规组(P<0.01).结论 通心络可通过降低血清ET、vWF和部分细胞粘附分子水平,提高NO水平等途径改善血管内皮功能,提高临床疗效.     

半剂量替罗非班对冠心病患者介入治疗后血管内皮功能的影响

目的:探讨半剂量替罗非班对冠心病患者经皮冠状动脉介入治疗(percutaneous coronary interventions,PCI)后血管内皮功能的影响。方法:将120例行PCI术的冠心病患者随机分为对照组和治疗组,对照组给予常规治疗;治疗组在常规治疗基础上给予半剂量替罗非班治疗。比较两组患者血流介导的肱动脉内皮依赖性舒张功能(flow-mediated brachial artery endothelium-dependent vasodilation,FMD)、一氧化氮(nitric oxide,NO)、内皮素-1(endothelia-1,ET-1)、血管性血友病因子(von willebrand factor,vWF)水平。结果:治疗组患者术后FMD、NO水平较对照组升高,ET-1和vWF水平较对照组降低,差异具有统计学意义(P<0.05)。结论:半剂量替罗非班能够改善冠心病患者PCI术后血管内皮功能,可能与其调节NO、ET-1、vWF水平相关。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.