Statistical analysis
The primary analysis used a per-protocol analysis to focus on the efficacy of GDHT, including only patients who strictly followed the protocol. Intention-to-treat analysis was also conducted as a sensitivity analysis to provide insight into the effectiveness of GDHT in diverse clinical settings. Data are presented as mean ± standard deviation, median (interquartile range), or number and percentage. The normality of the distribution of continuous variables was tested using the Kolmogorov–Smirnov test. Continuous variables were analyzed using the Student’s 