Untargeted Metabolomics Analysis using LC-MSQTOF for Metabolite Profile Comparison between Patients with Myofascial Pain of Upper Trapezius Muscle versus Controls

Objective: This study aims to identify different biomarkers of Myofascial pain syndrome (MPS) using untargeted metabolomics screening. Materials and Methods: In a case-control study, serum samples from MPS patients (n = 19) and healthy controls (n = 10) were analyzed using reverse-phase liquid chromatography and mass spectrometry quadrupole time-of-flight (MS-QTOF). The resulted raw data was processed with Progenesis QI data analysis software. The HMBD database was used to identify the metabolites based on their fold change (>1.2), variable importance plot (>1) with P < 0.05. MetaboAnalyst 5.0 was used to generate metabolic network analysis for all identified metabolites. Results: The MPS group reported significantly higher pain on visual analog scale when compared with control while most of the other routine blood chemical profiles were not different. Twenty-seven metabolites were analyzed and identified with untargeted metabolomics analysis which could distinguish MPS patients from healthy controls. Inosine and chenodeoxycholic acid were abundant in the MPS group, whereas the others were low. Metabolites were divided into three categories: lipids, nucleotides, and organic compounds. Possible MPS metabolites included lysoSM (sphingomyelin), lysoPC (lysophosphatidylcholine), lysoPE (lysophosphatidylethanolamine), triglyceride, and inosine. Conclusion: These metabolite profiles, including glycerophospholipids mechanism and purine metabolism, indicate that the inflammatory process might be related to the mechanisms of MPS. A larger sample size, a different trigger point location, and modifications in therapy afterward should all be further explored

Court-Type Thai Traditional Massage for Patients with Intractable Peripheral Neuropathic Pain: a Randomized Controlled Trial

Objective: Neuropathic pain management involves both pharmacological and non-pharmacological interventions. Despite this, no prior research has demonstrated the efficacy of court-type Thai traditional massage (CTTM) for neuropathic pain relief. This study aimed to investigate the potential benefits of CTTM in alleviating neuropathic pain. Materials and Methods: A preliminary single-blind randomized controlled trial was conducted on 28 participants with peripheral neuropathic pain, who were equally assigned to 2 groups. Both groups received standard drug treatment; however, the intervention group additionally received CTTM and hot herbal compression, while the active control group only received HHC. The adjuvant treatments were administered twice weekly for 4 weeks (V1-V8). A follow-up was conducted 4 weeks posttreatment (V9). Outcome measures were assessed at V1, V4, V8, and V9 using a numerical rating scale and the Thai versions of the Neuropathic Pain Symptom Inventory, the Brief Pain Inventory, and the EQ‑5D‑5L health questionnaire. Results: The data revealed that the intervention and active control groups had statistically significant differences in their pain intensity scores (P < 0.001), total neuropathic pain intensity scores (P = 0.001), and utility of health scores (P = 0.007) during the follow-up period. When comparing outcomes between V1 and V8, the groups exhibited significant differences in pain reduction (P = 0.003) and quality of life (P = 0.027). Conclusion: This study provides initial evidence supporting the potential benefits of CTTM in alleviating peripheral neuropathic pain and improving quality of life. Future research should further investigate the application of CTTM in managing peripheral neuropathic pain conditions

Rความสัมพันธ์ระหว่างลักษณะทางการแพทย์แผนไทยกับพฤติกรรมสุขภาพในผู้ป่วยโรคความดันโลหิตสูง Associations of Body Constituents in Thai Traditional Medicine with Health Behaviors in Patients with Hypertension

บทคัดย่อ   วัตถุประสงค์: เพื่อศึกษาปกติลักษณะทางการแพทย์แผนไทย และความสัมพันธ์ระหว่างปกติลักษณะกับพฤติกรรมสุขภาพของผู้ป่วยโรคความดันโลหิตสูง วิธีการศึกษา: การศึกษาแบบภาคตัดขวางในผู้ป่วยถูกวินิจฉัยโรคความดันโลหิตสูงจากแพทย์แผนปัจจุบัน ที่คลินิกอายุรเวทแพทย์แผนไทยประยุกต์ โรงพยาบาลศิริราช 374 คน ให้ตอบแบบสอบถามข้อมูลทั่วไป ประเมินปกติลักษณะ และพฤติกรรมสุขภาพ ทดสอบความสัมพันธ์ด้วย Chi-square test หรือ Fisher extract test ตามความเหมาะสม ผลการศึกษา: ผู้ป่วยส่วนใหญ่มีปกติลักษณะเป็นเสมหะ ความเครียดพบมากในผู้ที่มีปกติลักษณะแบบปิตตะ-วาตะมากที่สุด ส่วนการกินอาหารที่เติมน้ำตาลหรือเกลือพบมากที่สุดในในแบบเสมหะ วาตะ-เสมหะ ปิตตะ-เสมหะ การออกกำลังกายอย่างหนักพบในแบบปิตตะ และวาตะ ส่วนการออกกำลังกายปานกลางสัมพันธ์กับแบบวาตะอย่างมีนัยสำคัญทางสถิติ (P-value = 0.016, 0.005, 0.006 และ 0.016 ตามลำดับ) ส่วนพฤติกรรมสุขภาพด้านอื่นไม่พบว่าสัมพันธ์ปกติลักษณะใด สรุป: ผู้ที่มีโรคความดันโลหิตสูงมีปกติลักษณะแบบเสมหะมากที่สุด และความเครียด การกินอาหารที่เติมน้ำตาลและเกลือ การออกกำลังกายทั้งหนักและปานกลางล้วนสัมพันธ์กับปกติลักษณะ สามารถไปเสริมการปรับเปลี่ยนพฤติกรรมสุขภาพให้เหมาะกับปกติลักษณะตามแนวทางแพทย์แผนไทยได้ คำสำคัญ: พฤติกรรมสุขภาพ, ปกติลักษณะ, การแพทย์แผนไทย, โรคความดันโลหิตสูง Abstract Objective: To assess body constituents based on Thai traditional medicine (TTM) and its associations with health behaviors in hypertensive patiets. Methods: Cross-sectional study recruited 374 patients receiving at the Applied Thai Traditional Medicine Clinic, Siriraj Hospital. They were asked to complete questionnaires of demographic characteristics, body constituents, and health behaviors. Associations were tested using Chi-square test or Fisher’s exact test as appropriate. Results: Most participants had body constituents of phlegm type, followed by water and water-wind types. Stress was found the most in persons with water-wind type, high risk of consuming foods with sugar and salt added with phlegm, wind-phlegm, and water-phlegm types, heavy exercise with water and wind types, and moderate exercise with wind type with statistical significance (P-value = 0.016, 0.005, 0.006 and 0.016, respectively). Other health behaviors were not associated with body constituents. Conclusion: Hypertensive patients had body constituent of phlegm type the most. Stress, consumption of food with sugar and salt, and heavy and moderate exercise were associated with certain body constituents. The findgings could be applied in TTM in promoting healthy lifestyle in accordance with the individuals’ body constituent types.   Keywords: health behavior, body constituent, Thai traditional medicine, hypertensio

The Efficacy of Thai Herbal Prasaplai Formula for Treatment of Primary Dysmenorrhea: A Short-Term Randomized Controlled Trial

This study aims to compare the efficacy of pain relief between a specific Thai herbal Prasaplai formula (PPF) and placebo in patients with primary dysmenorrhea. Forty women with primary dysmenorrhea symptoms were randomized into two groups. The experimental group received PPF capsules 1000 mg orally three times per day before meals for three days starting from the first day of menstruation. The placebo group received placebo as the same dose and time. Average pain intensity from the first day to the third day of cycle significantly decreased in both groups ( &lt; 0.001), but with no statistically significant difference between groups. Using a pre-and posttreatment difference in NRS of at least 2, a greater proportion of patients in PPF group experienced pain relief compared to placebo during the first and second day of period. A greater proportion of PPF group also experienced no pain compared to the placebo group on day 1 and day 3 by using multidimensional scoring. The PPF demonstrates pain relief activity when used during menstruation in primary dysmenorrhea patients, with no adverse effects. However, further studies are needed in order to assess the value of PPF as a long-term prophylaxis for primary dysmenorrhea

The Efficacy of Thai Herbal Prasaplai Formula for Treatment of Primary Dysmenorrhea: A Short-Term Randomized Controlled Trial

This study aims to compare the efficacy of pain relief between a specific Thai herbal Prasaplai formula (PPF) and placebo in patients with primary dysmenorrhea. Forty women with primary dysmenorrhea symptoms were randomized into two groups. The experimental group received PPF capsules 1000 mg orally three times per day before meals for three days starting from the first day of menstruation. The placebo group received placebo as the same dose and time. Average pain intensity from the first day to the third day of cycle significantly decreased in both groups (p<0.001), but with no statistically significant difference between groups. Using a pre- and posttreatment difference in NRS of at least 2, a greater proportion of patients in PPF group experienced pain relief compared to placebo during the first and second day of period. A greater proportion of PPF group also experienced no pain compared to the placebo group on day 1 and day 3 by using multidimensional scoring. The PPF demonstrates pain relief activity when used during menstruation in primary dysmenorrhea patients, with no adverse effects. However, further studies are needed in order to assess the value of PPF as a long-term prophylaxis for primary dysmenorrhea