El-Shanshory Mohamed, Hablas Nahed M, Shebl Yasmin, Fakhreldin Ahmed R, Attia Mohamed, Almaramhy Hamdi H, Baghdadi Hussam, Ayat Mongi, Albeihany Amal, El-Dardear Amr, Ibrahim Hoda Ali, Mahmoud Hany Salah, Nabo Manal Mohamed Helmy, El Sayed Salah Mohamed
Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia,
Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt.
J Blood Med. 2018 Dec 14;9:241-251. doi: 10.2147/JBM.S170523. eCollection 2018.
Thalassemia is a major health problem due to iron overload, iron deposition and oxidative stress-induced tissue damage. Here, we introduce Al-hijamah (a minor surgical excretory procedure) as a novel percutaneous iron excretion therapy. Al-hijamah is a wet cupping therapy of prophetic medicine, and prophet Muhammad, peace be upon him, strongly recommended Al-hijamah, saying: "The best of your treatment is Al-hijamah".
Our study aimed at investigating the safety, iron chelation, pharmacological potentiation and oxidant clearance effects exerted by Al-hijamah to thalassemic children.
Ethical committee's approval and patients' written agreement consents were obtained. We treated 20 thalassemic children (15 males and five females aged 9.07±4.26 years) with iron chelation therapy (ICT) plus Al-hijamah (using sterile disposable sets and in a complete aseptic environment) vs a control group treated with ICT only. This clinical trial was registered in the ClinicalTrial.gov registry under the name "Study of the Therapeutic Benefits of Al-hijamah in Children with Beta Thalassemia Major" (identifier no NCT 02761395) on 30 January 2016.
Al-hijamah was quite simple, safe, effective, tolerable (with no side effects) and time-saving procedure (30-60 minutes). A single session of Al-hijamah significantly reduced iron overload (<0.001) in all thalassemic children. Al-hijamah significantly decreased serum ferritin by 25.22% (from 3,778.350±551.633 ng/mL to 2,825.300±558.94 ng/mL), significantly decreased oxidative stress by 68.69% (<0.05; serum malondialdehyde dropped from 42.155±12.42 to 13.195±0.68 nmol/L), exerted pharmacological potentiation to ICT and significantly increased total antioxidant capacity (<0.001) by 260.95% (from 13.195±0.68 nmol/L to 42.86±12.40 nmol/L through excreting reactive oxygen species). Moreover, therapeutic indices for evaluating Al-hijamah were promising.
Al-hijamah is a novel, safe, effective percutaneous iron excretion therapy through percutaneous iron excretion with minimal blood loss in agreement with the evidence-based Taibah mechanism. Al-hijamah is an effective outpatient hematological procedure that is safer than many pediatric procedures such as catheterization, hemofiltration and dialysis. Increasing the number of cups during Al-hijamah session or the number of sessions reduces iron overload more strongly. Medical practice of Al-hijamah is strongly recommended in hospitals.
地中海贫血是一个主要的健康问题，因为铁过载、铁沉积以及氧化应激诱导的组织损伤。在此，我们引入阿吉玛（一种小型外科排泄程序）作为一种新型的经皮铁排泄疗法。阿吉玛是先知医学的一种湿拔罐疗法，先知穆罕默德（愿主福安之）强烈推荐阿吉玛，他说：“你们最好的治疗方法就是阿吉玛”。
我们的研究旨在调查阿吉玛对地中海贫血儿童所产生的安全性、铁螯合、药理增强及氧化剂清除作用。
获得了伦理委员会的批准以及患者的书面同意书。我们对20名地中海贫血儿童（15名男性和5名女性，年龄9.07±4.26岁）采用铁螯合疗法（ICT）加阿吉玛（使用无菌一次性器械并在完全无菌的环境中）进行治疗，与仅接受ICT治疗的对照组进行对比。该临床试验于2016年1月30日在ClinicalTrial.gov注册，名称为“阿吉玛对重型β地中海贫血儿童治疗益处的研究”（标识符编号NCT 02761395）。
阿吉玛是一种非常简单、安全、有效、可耐受（无副作用）且节省时间的程序（30 - 60分钟）。单次阿吉玛治疗显著降低了所有地中海贫血儿童的铁过载（<0.001）。阿吉玛使血清铁蛋白显著降低了25.22%（从3,778.350±551.633 ng/mL降至2,825.300±558.94 ng/mL），使氧化应激显著降低了68.69%（<0.05；血清丙二醛从42.155±12.42降至13.195±0.68 nmol/L），对ICT发挥了药理增强作用，并通过排出活性氧使总抗氧化能力显著增加了260.95%（从13.195±0.68 nmol/L增至42.86±12.40 nmol/L）。此外，评估阿吉玛的治疗指标很有前景。
阿吉玛是一种新型、安全、有效的经皮铁排泄疗法，通过经皮铁排泄且失血极少，符合循证泰巴机制。阿吉玛是一种有效的门诊血液学程序，比许多儿科程序如导管插入术、血液滤过和透析更安全。在阿吉玛治疗过程中增加火罐数量或治疗次数能更有效地降低铁过载。强烈建议医院开展阿吉玛的医学实践。
