Integrative Medicine Hospital Research Articles

The Retrospective Study of Advanced Cancer Patients Receiving Integrative Cancer Treatments in single Comprehensive and Integrative Medicine Hospital

Objectives: Traditional Korean medicine (TKM) has been supplied as part of a national health care system in South Korea under a dual medical system, however it has been difficult to mix western medicine and TKM medical practices in existing hospitals. For the objective of innovative integration between them, Comprehensive and Integrative Medicine Hospital were founded in Daegu, South Korea. Here, we discussed the clinical outcomes of cancer patients who received integrative cancer treatment (ICT).Methods: A total of 678 patients previously diagnosed with cancer were retrospectively checked in our institution for 2 years. After applying inclusion/exclusion criteria, 573 patients were eligible for the final analysis. The overall survival (OS) of these patients in the aftercare period were determined. We looked at how clinical factors and treatments including chemotherapy, complementary and alternative medicine (CAM), and TKM affected the OS.Results: At the first visit, 212 subjects had no evidence of disease after tumor resection and 355 ones with advanced cancer, who receiving ICT including chemotherapy, CAM, and TKM showed better OS compared to the CAM including TKM or the best supportive care (median OS = 216, 78, and 46 days, respectively). The median OS was not reached in TKM only, even though the sample size was small (N = 12). Even after adjusting for clinical factors associated to liver, renal, and hematologic manifestation, ICT still remained significant.Conclusions: We demonstrated that ICT might be beneficial for advanced cancer regardless of the performance status, liver and renal function, since it positively affected the OS.

Clinical practice status of the adjuvant therapy in hepatocellular carcinoma (HCC): A survey of Chinese hepatobiliary surgeons.

e16127 Background: There are different views on the scope of indications for surgical treatment of HCC worldwide. Unlike the Barcelona Clinic Liver Cancer, the European Association for Study of the Liver, and the American Association for the Study of Liver Diseases which recommend surgical resection as the first choice only for early HCC, it is also recommended as the first treatment for selected patients with intermediate or advanced HCC in China. However, in any case, postoperative recurrence is an important issue affecting the long-term survival of HCC patients, and to date, there is no globally recognized treatment algorithm for adjuvant therapy. We performed a survey to understand the patient characteristics and clinical status of hepatobiliary surgeons’ decision aids for adjuvant treatment. Methods: This survey was conducted among senior hepatobiliary surgeons who work at high-volume hospitals in China. Surgeons were asked to fill out an online questionnaire by scanning the QR code. Results: From September to November 2021, 511 surgeons from 55 cities responded. Among them, 70.3% worked in general hospitals, 26.8% in cancer hospitals, and 2.9% in integrative medicine hospitals. The majority of the institutions were tertiary hospitals (91.2 %). When determining whether a patient was suitable or not for adjuvant therapy, surgeons mainly considered tumor factors (chosen by 92.8% and 81.6%) and patient factors (chosen by 80.8% and 75.3%). The analysis showed that the patients whom surgeons considered for adjuvant therapy had one or more of the following characteristics: Tumor factors including China liver cancer (CNLC) stage Ia-IIIb (preoperative), R1 resection, Child-Pugh A or B liver function, well recovery from surgery, presence of ≥1 high-risk recurrence factors (i.e. microvascular invasion, macrovascular tumor thrombus, and hilar lymph node metastasis); Patient factors which were hepatocarcinoma-related medical history (e.g., HBV/HCV) and affordability. Most surgeons used targeted therapy (83.8%, mainly anti-angiogenic multi-kinase inhibitors), TACE (72.8%), or combination therapy (60.3%, mainly targeted drugs combined with immunotherapy or TACE) as adjuvant therapy. When asked to choose the two most related factors impacting treatment compliance, 52.1% chose patients' financial status, and 51.7% considered adverse reactions. Less adverse reactions (71.0% of surgeons), better efficacy (66.7%), and a higher reimbursement ratio (53.3%) were the top 3 unmet need for future adjuvant therapy. Conclusions: This survey presented a patient portrait that Chinese hepatobiliary surgeons considered for adjuvant therapy and the practice patterns in adjuvant therapy for HCC. However, the patient group that can benefit from adjuvant therapy remains to be explored and validated in prospective clinical studies.

A pilot clinical study of an add-on Ayurvedic formulation containing Tinospora cordifolia and Piper longum in mild to moderate COVID-19

BackgroundAfter declaration of COVID- 19 as pandemic by WHO, countries adopted several measures to contain the spread as well as test and treat the patients. Further, as no effective management protocols to address this pandemic were available, a need was felt to explore the integration of modern and traditional medicines to treat COVID- 19 cases. ObjectiveTo undertake a study with Ayurveda formulation as add on to existing standard of care (SOC) and to compare the outcomes in terms of patient acceptability, the time to clinical recovery, hospital stay as well as any signs of drug-herb interaction between the Ayurveda formulation and the SOC. Material and methodsAn exploratory nonrandomized prospective study has been undertaken for comparing the outcomes of traditional Ayurvedic classical formulation of Tinospora cordifolia (Guduchi) and Piper longum (Pippali) as an add on to standard of care (SOC) using modern medicine with SOC alone. This has been done in mild and moderate COVID- 19 cases, at a tertiary care integrative Medicine hospital in the National Capital Region, Gurgaon, India. The outcomes have been evaluated in terms of the duration of hospital stay, the time to clinical recovery, safety and non- interference/interaction of Ayurvedic and Further, long term impact of COVID- 19 treatment has been evaluated using quality of life questionnaire after 3 months of discharge. ResultsFindings of present study reveals that the Ayurveda add-on formulation of T. cordifolia (Guduchi) and P. longum (Pippali) has reduced the length of hospital stay and improve the recovery time. General feeling of wellbeing and activity levels were better in the 3 month follow-up post discharge in the Ayurveda add-on group. ConclusionAddition of Ayurveda formulation has reduced the time of recovery and duration of hospital stay. However, this formulation needs further investigated to provide more information on effective and safe herbal add-on to SOC for better outcomes to treatment of COVID-19 disease.

Hospital-based health technology assessment: The next frontier for traditional Chinese medicine hospitals

Hospital-based health technology assessment (HB-HTA) is highly valuable in the application of hospital medical technology, cost control, improvement of medical quality, and protection of medical safety, and its use is increasing daily globally. However, in China, HB-HTA is still in its infancy, and it is yet to be adopted in traditional Chinese medicine (TCM). Therefore, this article introduces the application and development of HB-HTA, as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM. We conclude and recommend that all major stakeholders, including the state, health departments, and hospital leaders, support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals. We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development, as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects. Moreover, we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.

Sense of coherence in long-term follow-up of adolescents with anorexia nervosa

Background Sense of coherence (SOC) is a personal resource that allows people to stay healthy in spite of stressful situations. SOC is known to be low in eating disorders. We explored whether SOC correlated with anorexia nervosa (AN) symptoms several years after initial hospitalization for AN, to inform us whether AN treatment concepts could more specifically focus on increasing SOC. Methods Former patients were contacted 5–11 years after hospitalization for AN in a German integrative medicine hospital. Participants completed the Eating Disorder Inventory (EDI-2) and the SOC Questionnaire (SOC-13). Hospital records were reviewed. Correlations between EDI-2 subscales and SOC-13 were tested. A t-test was conducted to assess the difference between the SOC-13 and the norm. A median split was performed, dividing SOC scores into two groups and comparing these with EDI-2 subscales. Results Of 149 previously hospitalized female patients, 83 could be contacted and 68 agreed to participate (46%). 17.6% self-reported that they currently suffered from an eating disorder. The mean follow-up time was 7.2 years. All EDI-2 subscales correlated negatively with the SOC-13 score (p < .01). The mean SOC was significantly lower than the norm (p < .001). In the median split, the lower SOC group had significantly higher scores on all EDI-2 subscales. Conclusions Amongst previously hospitalized AN patients, the SOC was lower than a normative sample and correlated with on-going eating disorder symptoms in long-term follow-up. Strengthening SOC as a personal resource should be incorporated as a specific goal in AN treatment and its impact on long-term outcomes evaluated.

Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: study protocol for a single-center randomised controlled trial

IntroductionCognitive impairment, an important complication in patients with chronic obstructive pulmonary disease (COPD), seriously affects self-management of the disease and quality of life (QoL). As an exercise-based intervention programme, pulmonary...

Restrictive antibiotic use in children hospitalized for pneumonia: A retrospective inpatient study

IntroductionReducing antibiotic use is a global priority, but the extent to which antibiotic prescriptions can be reduced in children hospitalized for community-acquired pneumonia is unknown. This study aimed to analyse the prescribing experience from a facility with a long-standing practice of restrictive antibiotic use. MethodsWe conducted a retrospective analysis of children from birth to 18 years, hospitalized for pneumonia at an integrative medicine hospital in Germany. Antibiotic prescription rate and clinical outcomes were analyzed. The Moreno Bacterial Pneumonia Score, a composite laboratory, clinical and radiologic score, was applied to estimate the proportion of viral and bacterial pneumonia. Results252 pneumonia episodes were included, with 172 categorized as probably viral and 80 as bacterial pneumonia. Antibiotic prescription rate was 32 % overall, 26 % for presumed viral and 51 % for presumed bacterial pneumonia. Children with probable bacterial pneumonia who were managed with antibiotics had higher CRP values than those managed without antibiotics (p < 0.001). 13 % of bacterial pneumonia episodes initially managed without antibiotics received antibiotics after hospital day 2. Hospitalization duration was longer for bacterial pneumonia episodes managed with antibiotics than those managed without (7.0 versus 4.9 days, p = 0.003). ConclusionsThe observed antibiotic prescription rate of 32 % was much lower than rates reported in the literature - 88–98 %. Children were safely managed with a restrictive antibiotic prescription strategy when physicians judged this to be appropriate. Our findings suggest that a delayed prescription strategy for childhood pneumonia deserves further study. Trial registrationthe study was registered at clinicaltrials.org, NCT03256474.

Evaluation of isokinetic muscle strength of upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients.

BackgroundUpper limb muscle strength plays an important role in respiratory and pulmonary function, and limited research focuses on the role of strength and endurance of the elbow extensor and flexor. This study was conducted to accurately assess upper limb muscle function and quantified associations with pulmonary function and respiratory muscle strength in patients with stable chronic obstructive pulmonary disease (COPD).MethodsIn this cross-sectional study, patients with stable COPD treated in Yue-Yang Integrative Medicine Hospital from March 2014 to March 2016 were recruited. All participants underwent a pulmonary function test (forced expiratory volume in first second/forced vital capacity, FEV1/FVC; percentage value of predicted FEV1, FEV1%pred), a respiratory muscle strength test (maximal inspiratory pressure, MIP; maximal expiratory pressure, MEP), and an isokinetic test of dominant upper limb after a 24-hr interval (peak torque, PT; PT/body weight, PT/BW; total work, TW; endurance ratio, ER).ResultsA total of 88 patients with stable COPD (age: 65.5±8.7 years) were recruited, of which 73% (64 patients) were male. In the multiple stepwise regression analysis, sex remained as significant impactors in the final model for FEV1%pred (adjusted R2=0.243, P<0.001). Elbow flexor PT/BW and ER, sex, and BMI remained as significant impactors in the final model for FEV1/FVC (adjusted R2=0.255, P<0.01). Elbow flexor TW remained as significant impactors for MIP (adjusted R2=0.112, P=0.001), while elbow extensor PT and PT/BW and sex remained as significant impactors for MEP (adjusted R =0.385, P<0.01).ConclusionIn stable COPD, pulmonary function and respiratory muscle strength are associated with upper limb muscle strength. In particular, elbow flexor endurance is likely an important impactor for pulmonary function and inspiratory muscle strength, while elbow extensor strength is of importance for expiratory muscle strength.

Effects of home-based prescribed pulmonary exercise by patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial

BackgroundChronic obstructive pulmonary disease (COPD) not only affects pulmonary function but also leads to skeletal muscle dysfunction. The various characteristics of different forms of traditional Chinese exercise lead to inconsistent clinical effects in COPD patients. Hence, the present study carefully combined and rearranged liuzijue, wuqinxi, baduanjin, and yijinjing into a pulmonary exercise program targeting COPD patients.Methods/designThis study is a single-blind, randomized controlled trial. A random number table will be generated by an independent person. Each number will be placed in a sealed opaque envelop to blind assignment. All outcome assessors will be blinded to group assignment.COPD patients between 40 and 80 years of age, with stable medical treatment and no regular participation in regular exercise in the last 6 months will be included. All participants will be recruited from the Respiratory Medicine Department of Yue-Yang Integrative Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.All participants will continue to follow their medical treatment. They will be randomly assigned to one of four groups in a 1:1:1:1 ratio: (1) usual care (control group, CG), (2) pulmonary exercise group (PG), (3) resistance exercise group (RG), or (4) combined pulmonary exercise and resistance exercise group (PRG). CG participants will receive medical treatment only. PG participants will perform 60 min of exercise twice a day 7 days a week for 3 months, with 1 day’s exercise per week at hospital under guidance and supervision. RG participants will perform 60 min of resistance exercise once a day, three times a week for 3 months, with 1 day’s exercise per week at hospital under guidance and supervision. PRG participants will perform 60 min of prescribed pulmonary exercise combined with resistance exercise for 3 months.The outcomes include the isokinetic strength of peripheral skeletal muscle, surface electromyography, 6-min walking distance, 30-s arm curl test, pulmonary function, respiratory muscle strength, dyspnea, body composition, physical activity, quality of life, and Chronic Disease Self-Efficacy Scale.DiscussionThe results of this study will compensate for the current inadequate understanding of prescribed pulmonary exercise and may provide a new, simple, convenient, and effective home-based exercise intervention for COPD patients.Trial registrationChinese Clinical Trial Registry, ChiCTR-1800017405. Registered on 28 July 2018.

Clinical efficacy of cinacalciclovir hydrochloride combined with low-dose calcitriol in the treatment of patients with secondary hyperparathyroidism of end stage renal disease

Objective To investigate the effect of cinacalcet combined with low-dose calcitriol in the treatment of patients with secondary hyperparathyroidism of end-stage renal disease. Methods A prospective analysis was conducted in 129 patients with end-stage renal disease and secondary hyperparathyroidism from April 2015 to August 2017 in the Department of Nephrology of Integrative Medicine Hospital of Wenzhou City, Zhejiang Province.The patients were randomly divided into 3 groups: group A received cinacalcet, group B received calcitriol, group C received cinacalcet and low-dose calcitriol for 3 months, respectively.Before and after treatment, the levels of serum phosphorus and serum calcium in the three groups were measured.The levels of parathyroid hormone and the parathyroid hormone clearance rate were measured to find out the therapeutic effect. Results The levels of serum calcium, phosphorus and total parathyroid hormone in group A were significantly lower than those before treatment(t=3.269, 2.263, 4.233, all P 0.05). The total parathyroid hormone level: group B> group A > group C, the whole parathyroid hormone clearance rate: group C > group A > group B, the differences were statistically significant(t=3.642, 3.263, all P group C> group A, the serum phosphorus level among the three groups after treatment had statistically significant difference, group B> group A > group C (t=3.265, 3.332, all P<0.05). Conclusion The combined use of cinacalcet and low-dose calcitriol in the treatment of secondary hyperparathyroidism in patients with end-stage renal disease can significantly reduce the level of parathyroid hormone and serum phosphorus, and without affecting serum calcium concentration. Key words: Hyperparathyroidism; Kidner disease; Calcitriol; Sillocaine; Phosphorus; Calcium

Practice and experience of traditional Chinese medicine clinical pharmacy in integrative medicine hospital

目的 探讨中药临床药学的工作模式的建立和意义。 方法 介绍我院临床中药师深入临床、开设门诊、用药合理性评价、信息化药学服务的方法和成效。 结果 建立有效可行的中药临床药学工作实践模式，可以为患者提供高质量的临床中药学服务，并促进中药临床药学学科发展和服务水平提升。 结论 随着医疗改革的不断深入，中药临床药学工作的广泛开展必将是大势所趋。

Utilization Status and Satisfaction with Medical Services in Nonresidential Foreign Medical Tourists Visiting a Korean Medicine Hospital.

Medical tourism refers to international patient travel with the intent of receiving medical care. Recently, South Korea, armed with a dual medical system of conventional and traditional Korean medicine, has been gaining international standing in this industry. This study examined the characteristics, medical service use, and satisfaction of foreign patients who visited a spine-specialty Korean medicine hospital as musculoskeletal disorders are the highest frequency category of medical conditions treated using Korean medicine. The electronic medical records of 1,733 foreign patients who had first visited an integrative Korean medicine hospital in 2012–2015 were analyzed, and a satisfaction survey was conducted by e-mail along with phone calls and interviews. Female patients in their 40s with low back or neck pain comprised the most prevalent patient group. The most frequently used visiting channels were agencies, followed by recommendation by friends or family. Patients received an average of 5.25 sessions, and, based on analysis of 134 survey results, the highest satisfaction rates were associated with acupuncture and pharmacopuncture of provided treatments, high physician expertise, and reliability among medical services and coordinating and translating services among nonmedical factors. Overall, 90.2% replied that they were satisfied and 76.9% that their perception of Korean medicine had improved following treatment. Nonresidential foreigners who received integrative medicine treatment expressed high satisfaction, but visiting and promotion channels were shown to be limited, which connotes both the potential of Korean medicine in propelling Korea forward in the global medical tourism industry and the need for more systematic promotion of Korean medicine medical tourism.

A Case Study in Service Visualization: Comprehensive and Integrative Medicine Hospitals, Daegu

A Case Study in Service Visualization: Comprehensive and Integrative Medicine Hospitals, Daegu

A Case Study in Service Visualization: Comprehensive and Integrative Medicine Hospitals, Daegu

A Case Study in Service Visualization: Comprehensive and Integrative Medicine Hospitals, Daegu

Auricular acupuncture for spinal cord injury related neuropathic pain: a pilot controlled clinical trial

Objective: To obtain preliminary data on the effects of an auricular acupuncture protocol, Battlefield Acupuncture (BFA), on self-reported pain intensity in persons with chronic Spinal Cord Injury (SCI) and neuropathic pain.Design: Pilot randomized delayed entry single center crossover clinical trial at an outpatient rehabilitation and integrative medicine hospital center.Methods: Chronic (> one year post injury) ASIA impairment scale A through D individuals with SCI with injury level from C3 through T12 and below level neuropathic pain with at least five on the Numeric Rating Scale (NRS) were recruited. Twenty-four subjects were randomized to either an eight-week once weekly ten-needle BFA protocol (n = 13) or to a waiting list followed by the BFA protocol (n = 11).Outcome measures: The primary outcome measure was change in the pain severity NRS. Secondary outcome was the Global Impression of Change.Results: Demographically there were no significant differences between groups. Mean pain scores at baseline were higher in acupuncture than control subjects (7.75 ± 1.54 vs. 6.25 ± 1.04, P = 0.027). Although both groups reported significant reduction in pain during the trial period, the BFA group reported more pain reduction than the delayed entry group (average change in NRS at eight weeks –2.92 ± 2.11 vs. −1.13 ± 2.14, P = 0.065). There was a significant difference in groups when a group-by-time interaction in a mixed-effect repeated measures model (P = 0.014).Conclusion: This pilot study has provided proof of concept that BFA has clinically meaningful effect on the modulation of SCI neuropathic pain.

Analysis of 1157 cases of adverse drug reaction reports in Shanghai Baoshan District of Chinese Integrative Medicine Hospital from 2005 to 2011

Analysis of 1157 cases of adverse drug reaction reports in Shanghai Baoshan District of Chinese Integrative Medicine Hospital from 2005 to 2011

Effects of lifestyle behaviour change after a 14-day integrative medicine hospital inpatient stay

Effects of lifestyle behaviour change after a 14-day integrative medicine hospital inpatient stay

P04.22. Comparison of patient-centeredness and patient-reported health outcomes in integrative medicine hospitals with conventional hospitals in Germany

Purpose Integrative Medicine has been practiced in different hospitals in Germany for several decades. For example, several anthroposophic hospitals integrate conventional medicine with methods including the use of natural remedies, rhythmic embrocations, art therapy and biographic counseling. Moreover, patient-centeredness is a fundamental therapeutic approach especially in Integrative Medicine and many studies have shown significant positive influences on patient-reported physical and psychosocial outcomes. Thus, the purpose of our study is to compare patientreported health outcomes and patient–provider interaction of integrative medicine hospitals (IMH) with those of conventional hospitals.

Analysis on outcome of 5284 patients with coronary artery disease: The role of integrative medicine

Ethnopharmacological relevanceTraditional Chinese Medicine (TCM) has a history of thousands of years and has made great contributions to the health and well-being of the people. Integrative medicine (IM) treatment, combing TCM and conventional medicine, has been the most representative characteristic for coronary artery disease (CAD) patients in China, especially those in IM hospitals. However, the secondary prevention status of CAD and the potential benefit of IM therapy in improving CAD prognosis remains unclear. Materials and methodsBy means of a unified clinical and research information platform, we collected clinical information of hospitalized patients with CAD in cardiovascular department of 9 IM hospitals in Beijing and Tianjin from January 2003 to September 2006. The primary endpoints were major adverse cardiac events (MACEs) which include all-cause death in hospital and during one-year follow-up, acute myocardial infarction (AMI), percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). The diagnostic and therapeutic status of CAD patients was evaluated based on the latest available clinical guidelines. Meanwhile, a logistic stepwise regression analysis was also used to identify independent prognostic factors. Results5284 hospitalized patients with CAD were registered. The top five TCM patterns were in turn blood stasis 79.3%, Qi deficiency 56.5%, phlegm-turbidness 41.1%, Yin deficiency 24.8%, Yang deficiency 11.3%. The standard-reaching rate of CAD patients with hyperlipidemia was 85.6% for total cholesterol, 31.2% for triglyceride, 21.4% for low-density lipoprotein cholesterol, 52.5% for high-density lipoprotein cholesterol, while it was 61.9% and 80.9% in systolic and diastolic blood pressure of CAD with hypertension respectively. The top five commonly used herbs by functions were Qi-tonifying agents 89.25%, blood-activating agents 86.04%, Qi-regulating agents 77.60%, heat-clearing agents 67.50%, dampness-draining agents 65.95%. The herbs commonly used were Salvia miltiorrhiza Bunge 63.10%, Poria 59.99%, Raidx Astragali 49.67%, Radix Paeoniae Rubra 48.71%, peach seed 47.32%, angelica 46.82%, Radix Ligustici Chuanxiong 46.36%, safflower 45.40%, Pinellia 45.30%, glycyrrhiza 41.36%. 90 patients (1.7%) died in hospital, and the overall incidence of endpoints was 6.1% (322/5284). The logistic stepwise regress analysis showed that AMI (OR, 5.62, 95% CI=2.56–12.33), heart failure (OR, 2.68, 95% CI=1.67–4.29), age≥60 years (OR, 2.01, 95% CI=1.22–3.30), and medication of phosphodiesterase inhibitors (OR, 1.67, 95% CI=1.15–2.42) were independent risk factors for in-hospital mortality and one-year follow-up MACEs, while statins (OR, 0.23, 95% CI=0.06–0.91) and IM therapy (OR, 0.69, 95% CI=0.49–0.97) were protective factors. ConclusionThere was still certain gap between the usage of conventional medicine and clinical guideline in IM hospitals of China. Integrative Medicine might have potential benefit for CAD patients in reducing MACEs. However, the scheme of IM intervention and the mechanism of action are still needed to be further determined.

Changes of intestinal microflora in patients with rheumatoid arthritis during fasting and a Mediterranean diet

Background Therapeutic dietary interventions were often shown as effective treatment for rheumatoid arthritis (RA). Evidence 1a could be established for medical Fasting. The mechanisms to affect inflammation and clinical outcome are unknown. Alterations in intestinal microflora, especially the profile of short-chain-fatty-acids (SCFA) are believed to be associated with disease activity in patients with RA. Aim To evaluate changes in intestinal microflora and clinical outcome in RA during Fasting or a Mediterranean diet. We expect a greater influence of Fasting versus Mediterranean diet and a correlation between fasting response and alterations in SCFA. Methods In total, 50 consecutive patients from an Integrative Medicine Hospital were included in a prospective observational study. Patients received a 7-day Fasting therapy or a Mediterranean diet. Stool samples for gas-chromatographical analysis were taken at the beginning and at the end of a 2-week hospital stay. Disease activity of RA was assessed with DAS-28 and CRP was measured. Patients health assessment, self facility, pain and food consumption were evaluated with HAQ, SF-36, VAS and FFQ. Results DAS-28 decreased from 5.7±0.9 to 4.1±1.3 mean value in the fasting group and from 5.4±1.4 to 4.5±1.3 in non-fasters ( p =0.115). Pain on VAS significantly decreased from 4.1±2.3 at day 1 to 2.6±2.2 at day 7 in the fasting group versus 3.5±2.7 to 3.5±2.7 in the Mediterranean diet group ( p =0.049). CRP showed no significant difference ( p =0.759). No statistical differences between both groups were found in the profile of total-fatty-acids ( p =0.069), butyrate ( p =0.611) and propionate ( p =0.419), but measurement of acetate shows significant decrease from 17.4 μmol/g±9.8 to 21.4 μmol/g±16.4 in the fasting group compared to increasing values from 15.2 μmol/g±10.4 to 13.8 μmol/g±9.3 in the Mediterranean diet group ( p =0.044) (mean values). Conclusion Improvement of disease activity was comparable in both study groups. Pain decreased significantly on day 7 after Fasting therapy compared to Mediterranean diet and suggests a potential benefit of Fasting. Alterations in SCFA showed no significant differences except for the measurement of acetate. An association between anti-inflammatory properties of SCFA and disease activity in RA could not be shown.