Pub Date : 2026-02-01DOI: 10.1016/j.eujim.2026.102620
Uğur Doğan, Meltem Sungur
Introduction
Undergraduate nursing students commonly experience poor sleep quality due to irregular sleep patterns, academic pressures, clinical stressors, and excessive caffeine intake, yet the efficacy of the 4–7–8 breathing exercise has not been studied in this population. This study examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students.
Methods
This randomized controlled trial examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students at a public university in south-eastern Turkey. Recruited participants were randomly allocated using computer-generated block randomization to either an intervention group (n = 40) that practiced the technique nightly or a control group (n = 42) that received no intervention. The 4–7–8 breathing technique involves inhaling through the nose for 4 s, holding the breath for 7 s, and exhaling through the mouth for 8 s. Sleep quality was assessed pre- and post-intervention using the Pittsburgh Sleep Quality Index (PSQI).
Results
The intervention and control groups, which showed similar baseline characteristics including mean age (21.1 ± 0.7 vs 21.5 ± 2.0 years) and gender distribution (77.5% vs 78.6% female), both demonstrated poor sleep quality at baseline (PSQI > 5). Post-intervention, the intervention group showed significant improvements in total PSQI scores compared to the control group (mean difference:2.76; 95% CI:3.76 to -1.76). Significant between-group improvements were also found for the subscales of subjective sleep quality (mean difference: 0.51; 95% CI:0.78 to -0.24), sleep latency (mean difference: 0.54; 95% CI:0.91 to -0.18), sleep disturbances (mean difference: 0.47; 95% CI:0.71 to -0.22), and daytime dysfunction (mean difference: 0.91; 95% CI:1.25 to -0.56). The control group exhibited no significant changes excluding sleep disturbances. No adverse events were reported.
Conclusions
The 4–7–8 breathing exercise is an effective non-pharmacological intervention for improving sleep quality in undergraduate nursing students. These findings support its integrations into nursing education and clinical practice as a self-care tool and potential therapeutic modality for patients. Future research should explore long-term effects and applicability to other stressed populations.
{"title":"The effect of 4-7-8 breathing exercise training on sleep quality of undergraduate nursing students: A randomized controlled study","authors":"Uğur Doğan, Meltem Sungur","doi":"10.1016/j.eujim.2026.102620","DOIUrl":"10.1016/j.eujim.2026.102620","url":null,"abstract":"<div><h3>Introduction</h3><div>Undergraduate nursing students commonly experience poor sleep quality due to irregular sleep patterns, academic pressures, clinical stressors, and excessive caffeine intake, yet the efficacy of the 4–7–8 breathing exercise has not been studied in this population. This study examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students.</div></div><div><h3>Methods</h3><div>This randomized controlled trial examined the effects of a 4-week 4–7–8 breathing exercise intervention on sleep quality among undergraduate nursing students at a public university in south-eastern Turkey. Recruited participants were randomly allocated using computer-generated block randomization to either an intervention group (<em>n</em> = 40) that practiced the technique nightly or a control group (<em>n</em> = 42) that received no intervention. The 4–7–8 breathing technique involves inhaling through the nose for 4 s, holding the breath for 7 s, and exhaling through the mouth for 8 s. Sleep quality was assessed pre- and post-intervention using the Pittsburgh Sleep Quality Index (PSQI).</div></div><div><h3>Results</h3><div>The intervention and control groups, which showed similar baseline characteristics including mean age (21.1 ± 0.7 vs 21.5 ± 2.0 years) and gender distribution (77.5% vs 78.6% female), both demonstrated poor sleep quality at baseline (PSQI > 5). Post-intervention, the intervention group showed significant improvements in total PSQI scores compared to the control group (mean difference:2.76; 95% CI:3.76 to -1.76). Significant between-group improvements were also found for the subscales of subjective sleep quality (mean difference: 0.51; 95% CI:0.78 to -0.24), sleep latency (mean difference: 0.54; 95% CI:0.91 to -0.18), sleep disturbances (mean difference: 0.47; 95% CI:0.71 to -0.22), and daytime dysfunction (mean difference: 0.91; 95% CI:1.25 to -0.56). The control group exhibited no significant changes excluding sleep disturbances. No adverse events were reported.</div></div><div><h3>Conclusions</h3><div>The 4–7–8 breathing exercise is an effective non-pharmacological intervention for improving sleep quality in undergraduate nursing students. These findings support its integrations into nursing education and clinical practice as a self-care tool and potential therapeutic modality for patients. Future research should explore long-term effects and applicability to other stressed populations.</div></div><div><h3>The clinical trial registration number</h3><div>NCT06103344 (<span><span>http://clinicaltrials.gov/</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102620"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.eujim.2026.102619
Camille L. Garnsey , Katherine E. Gnall , Joshua A. Wilt , Crystal L. Park , Sara Lazar
<div><h3>Introduction</h3><div>Yoga practice is associated with improved emotional well-being (EWB), but little is known about the mechanisms of yoga that support EWB This post-hoc secondary analysis of a randomized controlled trial tested a) whether changes in self-compassion and interoceptive awareness were associated with changes in EWB (i.e., meaning in life, sense of inner peace, ability to pursue goals) over the course of a yoga intervention, and b) whether amount practiced relates to changes in proposed mechanisms and EWB outcomes.</div></div><div><h3>Methods</h3><div>Eighty-four participants who self-identified as stressed were randomized to varying doses of a 12-week Kripalu-style yoga intervention. As part of the parent clinical trial, participants completed self-report surveys at baseline, mid-treatment, and post-treatment assessing self-compassion (Self-Compassion Scale, Short Form), elements of interoceptive awareness (The Multidimensional Assessment of Interoceptive Awareness) and domains of emotional well-being (peace, meaning, ability to pursue goals; Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale; Brief Self Control Scale). Seventy-five participants from the parent study had data for at least one of the main study variables and were thus included in this secondary analysis. To examine whether changes in hypothesized mechanisms (self-compassion, interoceptive awareness) were associated with changes in EWB outcomes, standardized residuals reflecting relative change were obtained by regressing post-treatment scores on baseline scores for all variables. Then, partial correlations (controlling for gender, age and site) between the standardized residuals for changes in mechanisms and changes in EWB were examined. To examine a potential dose effect, partial correlations between average weekly practice and change in both mechanisms and three EWB outcomes were conducted, controlling for home-practice randomization group, gender, age, and study site.</div></div><div><h3>Results</h3><div>Over the course of the intervention (T1 to T3), changes in self-compassion were associated with changes in both meaning and peace (<em>r</em>s = 0.52, 0.54, respectively, <em>ps</em> < 0.001), but not with changes in ability to pursue goals (<em>r</em> = 0.15, <em>p</em> = .21). Over the course of the intervention (T1 to T3), changes in the interoceptive awareness subscale of trusting were associated with changes in peace (<em>r</em> = 0.35, <em>p=</em>.003) and changes in the attention regulation subscale were associated with changes in both meaning (<em>r</em> = 0.37, <em>p</em> = .001) and peace (<em>r</em> = 0.34, <em>p</em>=.003). Yoga dosage was associated with increases in self-compassion (<em>r</em> = 0.34, <em>p</em> = .04) only.</div></div><div><h3>Conclusions</h3><div>Findings provide promising preliminary evidence that yoga interventions and community classes may benefit from emphasizing self-compassion and body a
{"title":"Self-compassion and interoceptive awareness as mechanisms of change in yoga for emotional well-being: A secondary analysis of a randomized controlled trial","authors":"Camille L. Garnsey , Katherine E. Gnall , Joshua A. Wilt , Crystal L. Park , Sara Lazar","doi":"10.1016/j.eujim.2026.102619","DOIUrl":"10.1016/j.eujim.2026.102619","url":null,"abstract":"<div><h3>Introduction</h3><div>Yoga practice is associated with improved emotional well-being (EWB), but little is known about the mechanisms of yoga that support EWB This post-hoc secondary analysis of a randomized controlled trial tested a) whether changes in self-compassion and interoceptive awareness were associated with changes in EWB (i.e., meaning in life, sense of inner peace, ability to pursue goals) over the course of a yoga intervention, and b) whether amount practiced relates to changes in proposed mechanisms and EWB outcomes.</div></div><div><h3>Methods</h3><div>Eighty-four participants who self-identified as stressed were randomized to varying doses of a 12-week Kripalu-style yoga intervention. As part of the parent clinical trial, participants completed self-report surveys at baseline, mid-treatment, and post-treatment assessing self-compassion (Self-Compassion Scale, Short Form), elements of interoceptive awareness (The Multidimensional Assessment of Interoceptive Awareness) and domains of emotional well-being (peace, meaning, ability to pursue goals; Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale; Brief Self Control Scale). Seventy-five participants from the parent study had data for at least one of the main study variables and were thus included in this secondary analysis. To examine whether changes in hypothesized mechanisms (self-compassion, interoceptive awareness) were associated with changes in EWB outcomes, standardized residuals reflecting relative change were obtained by regressing post-treatment scores on baseline scores for all variables. Then, partial correlations (controlling for gender, age and site) between the standardized residuals for changes in mechanisms and changes in EWB were examined. To examine a potential dose effect, partial correlations between average weekly practice and change in both mechanisms and three EWB outcomes were conducted, controlling for home-practice randomization group, gender, age, and study site.</div></div><div><h3>Results</h3><div>Over the course of the intervention (T1 to T3), changes in self-compassion were associated with changes in both meaning and peace (<em>r</em>s = 0.52, 0.54, respectively, <em>ps</em> < 0.001), but not with changes in ability to pursue goals (<em>r</em> = 0.15, <em>p</em> = .21). Over the course of the intervention (T1 to T3), changes in the interoceptive awareness subscale of trusting were associated with changes in peace (<em>r</em> = 0.35, <em>p=</em>.003) and changes in the attention regulation subscale were associated with changes in both meaning (<em>r</em> = 0.37, <em>p</em> = .001) and peace (<em>r</em> = 0.34, <em>p</em>=.003). Yoga dosage was associated with increases in self-compassion (<em>r</em> = 0.34, <em>p</em> = .04) only.</div></div><div><h3>Conclusions</h3><div>Findings provide promising preliminary evidence that yoga interventions and community classes may benefit from emphasizing self-compassion and body a","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102619"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.eujim.2026.102618
Qiuyun Xue , Lixia Yuan , Jieyi Zhou , Wenxi Li , Hui Wang , Zijie Hong , Xu Zhou
Introduction
To develop a core outcome set (COS) for clinical research on traditional Chinese dietotherapy for type 2 diabetes (T2D).
Methods
We conducted a systematic search of nine literature databases for randomized controlled trials (RCTs) on traditional Chinese dietotherapy or herbal medicine for T2D published between 2020 and 2022, from which outcomes and effect estimates were extracted. This was supplemented with semi-structured interviews with clinicians and patients/family members to form a candidate outcome pool. A Delphi expert survey was then employed to evaluate the importance of each outcome. Finally, a consensus meeting was held to establish the COS.
Results
The systematic literature review included 94 RCTs and 5 trial registration protocols, yielding 233 outcomes. Semi-structured interviews supplemented this with 8 additional outcomes. After cleaning, merging, and refining, 115 outcomes were excluded, resulting in a final candidate pool of 126 outcomes. These were categorized by functional attribute into a hierarchical framework comprising four primary domains: efficacy, safety, cost, and compliance. In the subsequent Delphi survey, the first round invited 40 experts, with 32 participating (response rate 80.0%); the expert authority coefficient was 0.732. Among 73 outcomes with importance scores below 85 or a coefficient of variation greater than 0.2, 72 were excluded by consensus meeting vote, one was retained, and 6 clinician-suggested outcomes were added, resulting in 60 outcomes proceeding to the second round. The second Delphi round invited 29 experts (response rate 90.6%), and the authority coefficient increased to 0.767. From 31 outcomes considered for exclusion in this round, 28 were ultimately excluded, and 3 were retained after the consensus meeting vote. The final consensus meeting established the Core Outcome Set for traditional Chinese dietotherapy in T2D (COS-TCD-T2D), which includes 32 outcomes categorized into four primary domains: efficacy (22 outcomes, further divided into 10 subdomains), safety (6 outcomes), cost (2 outcomes), and compliance (2 outcomes).
Conclusion
This study successfully developed the COS-TCD-T2D, which consists of 32 outcomes. It can serve as a standardized tool for outcome selection in clinical research on traditional Chinese dietotherapy and may also be applicable to other complementary treatments for T2D.
{"title":"Development of a core outcome set for traditional Chinese dietotherapy in type 2 diabetes","authors":"Qiuyun Xue , Lixia Yuan , Jieyi Zhou , Wenxi Li , Hui Wang , Zijie Hong , Xu Zhou","doi":"10.1016/j.eujim.2026.102618","DOIUrl":"10.1016/j.eujim.2026.102618","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop a core outcome set (COS) for clinical research on traditional Chinese dietotherapy for type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>We conducted a systematic search of nine literature databases for randomized controlled trials (RCTs) on traditional Chinese dietotherapy or herbal medicine for T2D published between 2020 and 2022, from which outcomes and effect estimates were extracted. This was supplemented with semi-structured interviews with clinicians and patients/family members to form a candidate outcome pool. A Delphi expert survey was then employed to evaluate the importance of each outcome. Finally, a consensus meeting was held to establish the COS.</div></div><div><h3>Results</h3><div>The systematic literature review included 94 RCTs and 5 trial registration protocols, yielding 233 outcomes. Semi-structured interviews supplemented this with 8 additional outcomes. After cleaning, merging, and refining, 115 outcomes were excluded, resulting in a final candidate pool of 126 outcomes. These were categorized by functional attribute into a hierarchical framework comprising four primary domains: efficacy, safety, cost, and compliance. In the subsequent Delphi survey, the first round invited 40 experts, with 32 participating (response rate 80.0%); the expert authority coefficient was 0.732. Among 73 outcomes with importance scores below 85 or a coefficient of variation greater than 0.2, 72 were excluded by consensus meeting vote, one was retained, and 6 clinician-suggested outcomes were added, resulting in 60 outcomes proceeding to the second round. The second Delphi round invited 29 experts (response rate 90.6%), and the authority coefficient increased to 0.767. From 31 outcomes considered for exclusion in this round, 28 were ultimately excluded, and 3 were retained after the consensus meeting vote. The final consensus meeting established the Core Outcome Set for traditional Chinese dietotherapy in T2D (COS-TCD-T2D), which includes 32 outcomes categorized into four primary domains: efficacy (22 outcomes, further divided into 10 subdomains), safety (6 outcomes), cost (2 outcomes), and compliance (2 outcomes).</div></div><div><h3>Conclusion</h3><div>This study successfully developed the COS-TCD-T2D, which consists of 32 outcomes. It can serve as a standardized tool for outcome selection in clinical research on traditional Chinese dietotherapy and may also be applicable to other complementary treatments for T2D.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102618"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.eujim.2026.102616
Chunping Zheng, Luan Huang, Lijuan Tang, Chunbo Wu, Ruojun Luo
Introduction
Gastrointestinal dysfunction is a common complication in septic patients, contributing to adverse outcomes such as enteral nutrition intolerance, bacterial translocation, and increased mortality. While randomized controlled trials (RCTs) suggest that Traditional Chinese Medicine (TCM) external therapies may help manage this condition, the most effective therapy remains unclear. This review aims to evaluate the effectiveness of various TCM external therapies in improving gastrointestinal dysfunction in septic patients through a network meta-analysis.
Methods
We conducted a comprehensive search of eight databases for RCTs on TCM external therapies for gastrointestinal dysfunction in sepsis, published up to December 2024 and updated in June 2025. The Cochrane Risk of Bias 2.0 (RoB 2.0) tool was used to assess bias. A frequentist network meta-analysis was performed using Stata 18, calculating standardized mean difference (SMD) or weighted mean differences (WMD) for continuous outcomes, and risk ratios (RR) for binary outcomes, with 95% confidence intervals. Clinical significance was determined in conjunction with the minimal clinically important difference (MCID). Evidence quality was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework.
Results
Fifty studies involving 3999 participants were included, comparing 10 TCM external therapies. Among these, 41 (82%) raised concerns, and 9 (18%) were high-risk. CINeMA ratings were mainly “low” or “very low” confidence. Compared to conventional treatment (CT), CT combined with acupoint application increased the number of bowel sounds (WMD = 1.10; 95% CI: 0.75, 1.44), exceeding the MCID. Compared to CT, CT combined with Chinese herbal enema showed more extensive benefits, including a reduction in Acute Physiology and Chronic Health Evaluation II (APACHE II) score (WMD = -4.03; 95% CI: -4.96, -3.10), an improvement in gastrointestinal dysfunction score (SMD = -0.68; 95% CI: -0.99, -0.36), and decreased inflammatory markers (white blood cell count and procalcitonin), all of which were clinically significant. Both combined therapies also significantly enhanced the clinical effective rate compared to CT.
Conclusion
CT combined with Chinese herbal enema and CT combined with acupoint application offer distinct benefits in improving gastrointestinal dysfunction in sepsis. To validate these conclusions and establish a universally recognized MCID, large-scale, high-quality, and well-designed RCTs are needed.
{"title":"Traditional Chinese medicine external therapies for treating gastrointestinal dysfunction in sepsis: A network meta-analysis","authors":"Chunping Zheng, Luan Huang, Lijuan Tang, Chunbo Wu, Ruojun Luo","doi":"10.1016/j.eujim.2026.102616","DOIUrl":"10.1016/j.eujim.2026.102616","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastrointestinal dysfunction is a common complication in septic patients, contributing to adverse outcomes such as enteral nutrition intolerance, bacterial translocation, and increased mortality. While randomized controlled trials (RCTs) suggest that Traditional Chinese Medicine (TCM) external therapies may help manage this condition, the most effective therapy remains unclear. This review aims to evaluate the effectiveness of various TCM external therapies in improving gastrointestinal dysfunction in septic patients through a network meta-analysis.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search of eight databases for RCTs on TCM external therapies for gastrointestinal dysfunction in sepsis, published up to December 2024 and updated in June 2025. The Cochrane Risk of Bias 2.0 (RoB 2.0) tool was used to assess bias. A frequentist network meta-analysis was performed using Stata 18, calculating standardized mean difference (SMD) or weighted mean differences (WMD) for continuous outcomes, and risk ratios (RR) for binary outcomes, with 95% confidence intervals. Clinical significance was determined in conjunction with the minimal clinically important difference (MCID). Evidence quality was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework.</div></div><div><h3>Results</h3><div>Fifty studies involving 3999 participants were included, comparing 10 TCM external therapies. Among these, 41 (82%) raised concerns, and 9 (18%) were high-risk. CINeMA ratings were mainly “low” or “very low” confidence. Compared to conventional treatment (CT), CT combined with acupoint application increased the number of bowel sounds (WMD = 1.10; 95% CI: 0.75, 1.44), exceeding the MCID. Compared to CT, CT combined with Chinese herbal enema showed more extensive benefits, including a reduction in Acute Physiology and Chronic Health Evaluation II (APACHE II) score (WMD = -4.03; 95% CI: -4.96, -3.10), an improvement in gastrointestinal dysfunction score (SMD = -0.68; 95% CI: -0.99, -0.36), and decreased inflammatory markers (white blood cell count and procalcitonin), all of which were clinically significant. Both combined therapies also significantly enhanced the clinical effective rate compared to CT.</div></div><div><h3>Conclusion</h3><div>CT combined with Chinese herbal enema and CT combined with acupoint application offer distinct benefits in improving gastrointestinal dysfunction in sepsis. To validate these conclusions and establish a universally recognized MCID, large-scale, high-quality, and well-designed RCTs are needed.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102616"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.eujim.2026.102617
Bee Yean Low , Farida Hanim Islahudin
Introduction
The rising use of complementary and alternative medicine (CAM), particularly health and dietary supplements, alongside conventional therapies highlights the need for pharmacists to be knowledgeable and confident in guiding patients. In pharmacy practice, these product-based forms of CAM are the most commonly encountered. This study aimed to assess pharmacists’ knowledge, attitude and practice (KAP) towards CAM (operationally defined in this study as health and dietary supplements), examine interrelationships among these domains and explore the influence of demographic factors.
Methods
A cross-sectional survey was conducted between April and May 2025 among pharmacists in hospitals, health clinics and community pharmacies across Malaysia. Using convenience sampling, 150 responses were collected, with 141 valid responses analysed. A validated self-administered questionnaire (I-CVI: 0.83–1.00; S-CVI/Ave: 0.98–1.00) assessed KAP through 25 items. Descriptive statistics, Pearson correlation and Chi-square/Fisher’s exact tests were used for data analysis.
Results
Pharmacists demonstrated moderate knowledge (mean=6.26 ± 2.49), mixed attitude (mean=27.13 ± 3.37) and mixed practice (mean=12.44 ± 2.71) regarding health and dietary supplements as forms of CAM. Over half (50.3%) reported frequent use of these products and most provided counselling on interactions (67.4%) and adverse effects (53.9%). However, 57.4% never referred patients to CAM specialists, suggesting limited integration into broader healthcare networks. Despite mixed views, overwhelming support was reported for integrating CAM-related education into pharmacy curricula (97.2%) and the national healthcare system (84.3%). Significant positive correlations were found between knowledge and practice (r = 0.480, p < 0.001), attitude and practice (r = 0.295, p < 0.001), and knowledge and attitude (r = 0.204, p = 0.015), indicating that improvements in one area may positively influence others. Work setting, ethnicity, years of working experience and practice location significantly influenced knowledge scores.
Conclusion
Pharmacists’ engagement with CAM, primarily health and dietary supplements, was characterised by variable knowledge, attitude and practice. While openness was evident, gaps remain in delivering consistent, evidence-based guidance to patients. Structured education, standardised guidelines, equitable resource access and stronger regulatory support are needed. Targeted training and policy reform are vital to integrate pharmacists into collaborative, patient-centred care models while acknowledging the defined scope of CAM addressed in this study.
补充和替代医学（CAM），特别是保健和膳食补充剂的使用日益增加，与传统疗法一起，突出了药剂师在指导患者方面知识渊博和自信的必要性。在药学实践中，这些基于产品的CAM形式是最常见的。本研究旨在评估药师对CAM（本研究的操作定义为健康和膳食补充剂）的知识、态度和实践（KAP），考察这些领域之间的相互关系，并探讨人口因素的影响。方法于2025年4 - 5月对马来西亚各医院、卫生所和社区药房的药师进行横断面调查。采用方便抽样法，共收集问卷150份，分析有效问卷141份。经验证的自我管理问卷（I-CVI: 0.83-1.00; S-CVI/Ave: 0.98-1.00）通过25个项目评估KAP。采用描述性统计、Pearson相关和卡方/费雪精确检验进行数据分析。结果药师对保健品和膳食补充剂作为CAM形式的认知程度一般（平均=6.26±2.49），态度混合（平均=27.13±3.37），实践混合（平均=12.44±2.71）。超过一半（50.3%）的人报告经常使用这些产品，大多数人就相互作用（67.4%）和不良反应（53.9%）提供咨询。然而，57.4%的医生从未将患者转诊给CAM专家，这表明与更广泛的医疗保健网络的整合有限。尽管意见不一，但绝大多数人支持将cam相关教育纳入药学课程（97.2%）和国家医疗保健系统（84.3%）。知识与实践（r = 0.480, p < 0.001）、态度与实践（r = 0.295, p < 0.001）、知识与态度（r = 0.204, p = 0.015）之间存在显著正相关，表明某一领域的改进可能对其他领域产生积极影响。工作环境、种族、工作年限和实习地点对知识得分有显著影响。结论药师参与CAM（主要是保健品和膳食补充剂）的知识、态度和行为存在差异。虽然公开性很明显，但在向患者提供一致的循证指导方面仍然存在差距。我们需要结构化的教育、标准化的指导方针、公平的资源获取和更强有力的监管支持。有针对性的培训和政策改革对于将药剂师整合到协作，以患者为中心的护理模式中至关重要，同时承认本研究中解决的CAM的定义范围。
{"title":"Understanding pharmacists' engagement with selected forms of complementary and alternative medicine: A cross-sectional survey of health and dietary supplements","authors":"Bee Yean Low , Farida Hanim Islahudin","doi":"10.1016/j.eujim.2026.102617","DOIUrl":"10.1016/j.eujim.2026.102617","url":null,"abstract":"<div><h3>Introduction</h3><div>The rising use of complementary and alternative medicine (CAM), particularly health and dietary supplements, alongside conventional therapies highlights the need for pharmacists to be knowledgeable and confident in guiding patients. In pharmacy practice, these product-based forms of CAM are the most commonly encountered. This study aimed to assess pharmacists’ knowledge, attitude and practice (KAP) towards CAM (operationally defined in this study as health and dietary supplements), examine interrelationships among these domains and explore the influence of demographic factors.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted between April and May 2025 among pharmacists in hospitals, health clinics and community pharmacies across Malaysia. Using convenience sampling, 150 responses were collected, with 141 valid responses analysed. A validated self-administered questionnaire (I-CVI: 0.83–1.00; S-CVI/Ave: 0.98–1.00) assessed KAP through 25 items. Descriptive statistics, Pearson correlation and Chi-square/Fisher’s exact tests were used for data analysis.</div></div><div><h3>Results</h3><div>Pharmacists demonstrated moderate knowledge (mean=6.26 ± 2.49), mixed attitude (mean=27.13 ± 3.37) and mixed practice (mean=12.44 ± 2.71) regarding health and dietary supplements as forms of CAM. Over half (50.3%) reported frequent use of these products and most provided counselling on interactions (67.4%) and adverse effects (53.9%). However, 57.4% never referred patients to CAM specialists, suggesting limited integration into broader healthcare networks. Despite mixed views, overwhelming support was reported for integrating CAM-related education into pharmacy curricula (97.2%) and the national healthcare system (84.3%). Significant positive correlations were found between knowledge and practice (<em>r</em> = 0.480, <em>p</em> < 0.001), attitude and practice (<em>r</em> = 0.295, <em>p</em> < 0.001), and knowledge and attitude (<em>r</em> = 0.204, <em>p</em> = 0.015), indicating that improvements in one area may positively influence others. Work setting, ethnicity, years of working experience and practice location significantly influenced knowledge scores.</div></div><div><h3>Conclusion</h3><div>Pharmacists’ engagement with CAM, primarily health and dietary supplements, was characterised by variable knowledge, attitude and practice. While openness was evident, gaps remain in delivering consistent, evidence-based guidance to patients. Structured education, standardised guidelines, equitable resource access and stronger regulatory support are needed. Targeted training and policy reform are vital to integrate pharmacists into collaborative, patient-centred care models while acknowledging the defined scope of CAM addressed in this study.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102617"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-27DOI: 10.1016/j.eujim.2026.102622
Botan Xu , Fen Zhou , Guangyi Yang , Ziwei Wang , Zihan Zhao , Yishan Yu , Hao Wang , Bingjie Liu , Ting Yuan , Yuxi Wang
Introduction
Our overview aimed to evaluate the methodological quality, completeness of reporting, and evidence quality of systematic reviews (SRs) on the intervention of external therapy of traditional Chinese medicine (TCM) for Rheumatoid Arthritis (RA).
Methods
A computer-based search was conducted across four Chinese and three English databases from inception to November 30, 2025. For 33 pairwise meta-analyses, Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) were used for methodological and reporting quality assessment; five network meta-analyses used ISPOR-AMCP-NPC questionnaire and PRISMA Network Meta-analysis (NMA) extension statement. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the evidence quality, with Corrected Covered Area (CCA) analyzing original study duplication.
Results
A total of 38 SRs were included, with the AMSTAR 2 evaluation showing three SRs rated as moderate quality, 19 as low quality, and 11 as very low quality. The methodological quality of the network meta-analysis also has some flaws. The PRISMA 2020 statement and PRISMA NMA extension statement indicated that certain items in the included SRs were incomplete. The GRADE system assessment showed that the quality of results for SRs was mostly low or very low. The CCA was 0.013, indicating a low duplication rate of the original studies.
Conclusion
External therapies of TCM could improve the symptoms and signs of RA and have fewer side effects, with higher safety. However, the methodological quality, completeness of reporting, and evidence quality of the included SRs were relatively low, which had some impact on the accuracy of the results. Further studies with larger sample sizes and higher quality are needed.
{"title":"External therapy of traditional Chinese medicine for rheumatoid arthritis: An overview of systematic reviews","authors":"Botan Xu , Fen Zhou , Guangyi Yang , Ziwei Wang , Zihan Zhao , Yishan Yu , Hao Wang , Bingjie Liu , Ting Yuan , Yuxi Wang","doi":"10.1016/j.eujim.2026.102622","DOIUrl":"10.1016/j.eujim.2026.102622","url":null,"abstract":"<div><h3>Introduction</h3><div>Our overview aimed to evaluate the methodological quality, completeness of reporting, and evidence quality of systematic reviews (SRs) on the intervention of external therapy of traditional Chinese medicine (TCM) for Rheumatoid Arthritis (RA).</div></div><div><h3>Methods</h3><div>A computer-based search was conducted across four Chinese and three English databases from inception to November 30, 2025. For 33 pairwise meta-analyses, Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) were used for methodological and reporting quality assessment; five network meta-analyses used ISPOR-AMCP-NPC questionnaire and PRISMA Network Meta-analysis (NMA) extension statement. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the evidence quality, with Corrected Covered Area (CCA) analyzing original study duplication.</div></div><div><h3>Results</h3><div>A total of 38 SRs were included, with the AMSTAR 2 evaluation showing three SRs rated as moderate quality, 19 as low quality, and 11 as very low quality. The methodological quality of the network meta-analysis also has some flaws. The PRISMA 2020 statement and PRISMA NMA extension statement indicated that certain items in the included SRs were incomplete. The GRADE system assessment showed that the quality of results for SRs was mostly low or very low. The CCA was 0.013, indicating a low duplication rate of the original studies.</div></div><div><h3>Conclusion</h3><div>External therapies of TCM could improve the symptoms and signs of RA and have fewer side effects, with higher safety. However, the methodological quality, completeness of reporting, and evidence quality of the included SRs were relatively low, which had some impact on the accuracy of the results. Further studies with larger sample sizes and higher quality are needed.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"83 ","pages":"Article 102622"},"PeriodicalIF":1.7,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The ketogenic diet (KD) has attracted increasing attention for its potential to modulate the gut microbiota; however, the rapidly expanding literature makes it difficult to identify dominant themes, leading contributors, and research gaps. This study aimed to map global research trends on the KD–gut microbiota relationship using bibliometric methods.
Methods
A bibliometric analysis was conducted using the Scopus database. Records published between January 1, 2009 and December 31, 2024 were included (search updated to January 1, 2025). Bibliometric indicators and performance analyses were computed, and keyword co-occurrence and international collaboration networks were visualized using VOSviewer.
Results
A total of 404 documents were identified. Publication output increased markedly after 2016 and peaked in 2024, indicating growing scientific interest. The most prolific authors and institutions contributed disproportionately to the field, and thematic mapping revealed five dominant clusters, including neurodegenerative diseases, metabolic regulation, and microbiota-related mechanisms. While the field is expanding, the distribution of document types suggests that conceptual and synthesis work remains prominent.
Conclusion
Research on the KD–gut microbiota relationship has grown substantially over the last decade, with clear thematic consolidation around metabolic and neurological outcomes. Future studies should prioritize mechanistic and longitudinal clinical designs and integrate multi-omics approaches to clarify causal pathways and support personalized dietary interventions.
{"title":"Global research trends on the ketogenic diet–gut microbiota relationship: A bibliometric analysis","authors":"Emre Manisalı , Kaan Zıkşahna , Rumeysa Adıyıl , Murat Ihlamur","doi":"10.1016/j.eujim.2026.102615","DOIUrl":"10.1016/j.eujim.2026.102615","url":null,"abstract":"<div><h3>Introduction</h3><div>The ketogenic diet (KD) has attracted increasing attention for its potential to modulate the gut microbiota; however, the rapidly expanding literature makes it difficult to identify dominant themes, leading contributors, and research gaps. This study aimed to map global research trends on the KD–gut microbiota relationship using bibliometric methods.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted using the Scopus database. Records published between January 1, 2009 and December 31, 2024 were included (search updated to January 1, 2025). Bibliometric indicators and performance analyses were computed, and keyword co-occurrence and international collaboration networks were visualized using VOSviewer.</div></div><div><h3>Results</h3><div>A total of 404 documents were identified. Publication output increased markedly after 2016 and peaked in 2024, indicating growing scientific interest. The most prolific authors and institutions contributed disproportionately to the field, and thematic mapping revealed five dominant clusters, including neurodegenerative diseases, metabolic regulation, and microbiota-related mechanisms. While the field is expanding, the distribution of document types suggests that conceptual and synthesis work remains prominent.</div></div><div><h3>Conclusion</h3><div>Research on the KD–gut microbiota relationship has grown substantially over the last decade, with clear thematic consolidation around metabolic and neurological outcomes. Future studies should prioritize mechanistic and longitudinal clinical designs and integrate multi-omics approaches to clarify causal pathways and support personalized dietary interventions.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102615"},"PeriodicalIF":1.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.eujim.2026.102613
Lijun Pang , Yunfei Li , Lili Cheng , Junjie Chen , Ziheng Zhu , Zhongfu Tang , Chuanbing Huang
Introduction
Ankylosing spondylitis (AS) is a chronic inflammatory spondyloarthritis in which pharmacologic therapy alone often leaves residual pain, stiffness and functional limitation. Wuqinxi (Five-Animal Exercise) is a traditional Chinese mind–body practice that may provide anti-inflammatory and mobility benefits. This trial evaluated the add-on effects of a 12-week Wuqinxi programme combined with standard pharmacologic therapy on clinical, biomarker and imaging outcomes in patients with AS.
Methods
In this single-centre, randomized, parallel-group trial, 64 adults with AS receiving stable celecoxib and sulfasalazine were allocated to Wuqinxi plus standard care or standard care alone for 12 weeks. The primary outcome was change in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Key secondary outcomes were Bath Ankylosing Spondylitis Functional and Metrology Indices (BASFI, BASMI), spinal pain (visual analogue scale), and radiographic and MRI scores (modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS], Spondyloarthritis Research Consortium of Canada [SPARCC] sacroiliac joint score). Analyses followed the intention-to-treat principle and are reported as between-group mean differences in change with 95% confidence intervals (CIs).
Results
BASDAI improved in both groups but more with Wuqinxi (mean change −2.6 vs −2.1; between-group difference −0.58, 95% CI −1.10 to −0.05). Add-on Wuqinxi yielded larger gains in physical function and spinal mobility (BASFI difference −1.35, 95% CI −1.93 to −0.78; BASMI difference −1.63, 95% CI −2.15 to −1.10), and greater reductions in spinal pain (visual analogue scale difference −0.94, 95% CI −1.56 to −0.32). Structural and inflammatory scores also favoured Wuqinxi (mSASSS difference −5.31, 95% CI −8.49 to −2.14; SPARCC difference −6.31, 95% CI −8.59 to −4.04), accompanied by consistent improvements in health-related quality of life, spinal mobility measures and inflammatory biomarkers. No serious adverse events occurred; mild musculoskeletal soreness and gastrointestinal discomfort were infrequent and self-limited in both groups.
Conclusions
A 12-week, partially supervised Wuqinxi programme as an add-on to standard pharmacologic therapy improved disease activity, function, spinal mobility, quality of life, inflammatory biomarkers and MRI inflammation in patients with AS, with good short-term safety. Larger and longer trials are needed to confirm durability and structural benefits.
{"title":"Add-on effects of five-animal exercise in ankylosing spondylitis: A randomized controlled trial","authors":"Lijun Pang , Yunfei Li , Lili Cheng , Junjie Chen , Ziheng Zhu , Zhongfu Tang , Chuanbing Huang","doi":"10.1016/j.eujim.2026.102613","DOIUrl":"10.1016/j.eujim.2026.102613","url":null,"abstract":"<div><h3>Introduction</h3><div>Ankylosing spondylitis (AS) is a chronic inflammatory spondyloarthritis in which pharmacologic therapy alone often leaves residual pain, stiffness and functional limitation. Wuqinxi (Five-Animal Exercise) is a traditional Chinese mind–body practice that may provide anti-inflammatory and mobility benefits. This trial evaluated the add-on effects of a 12-week Wuqinxi programme combined with standard pharmacologic therapy on clinical, biomarker and imaging outcomes in patients with AS.</div></div><div><h3>Methods</h3><div>In this single-centre, randomized, parallel-group trial, 64 adults with AS receiving stable celecoxib and sulfasalazine were allocated to Wuqinxi plus standard care or standard care alone for 12 weeks. The primary outcome was change in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Key secondary outcomes were Bath Ankylosing Spondylitis Functional and Metrology Indices (BASFI, BASMI), spinal pain (visual analogue scale), and radiographic and MRI scores (modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS], Spondyloarthritis Research Consortium of Canada [SPARCC] sacroiliac joint score). Analyses followed the intention-to-treat principle and are reported as between-group mean differences in change with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>BASDAI improved in both groups but more with Wuqinxi (mean change −2.6 vs −2.1; between-group difference −0.58, 95% CI −1.10 to −0.05). Add-on Wuqinxi yielded larger gains in physical function and spinal mobility (BASFI difference −1.35, 95% CI −1.93 to −0.78; BASMI difference −1.63, 95% CI −2.15 to −1.10), and greater reductions in spinal pain (visual analogue scale difference −0.94, 95% CI −1.56 to −0.32). Structural and inflammatory scores also favoured Wuqinxi (mSASSS difference −5.31, 95% CI −8.49 to −2.14; SPARCC difference −6.31, 95% CI −8.59 to −4.04), accompanied by consistent improvements in health-related quality of life, spinal mobility measures and inflammatory biomarkers. No serious adverse events occurred; mild musculoskeletal soreness and gastrointestinal discomfort were infrequent and self-limited in both groups.</div></div><div><h3>Conclusions</h3><div>A 12-week, partially supervised Wuqinxi programme as an add-on to standard pharmacologic therapy improved disease activity, function, spinal mobility, quality of life, inflammatory biomarkers and MRI inflammation in patients with AS, with good short-term safety. Larger and longer trials are needed to confirm durability and structural benefits.</div></div><div><h3>Trial registration</h3><div>ITMCTR2024000756.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102613"},"PeriodicalIF":1.7,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uterine fibroids are prevalent among women of reproductive age. They have a negative impact on females' private and social life. As surgical and non-surgical approaches lead to some shortcomings such as reproduction failure, recurrence, and adverse effects of medications, complementary and integrative treatments have gained attention. Acupuncture is used for uterine fibroids in practice; however, the evidence is limited. This study aims to compare the effects of segmental electroacupuncture, manual acupuncture, and sham acupuncture on symptoms, mass size, and Doppler indices of uterine arteries in patients with uterine fibroids.
Methods
This study is a three-arm, sham-controlled, parallel-group, single-blinded, randomized clinical trial. Seventy-two cases with uterine fibroids type 1-6 according to the International Federation of Gynecology and Obstetrics classification will enter the study. They will be randomized into 3 groups, segmental electroacupuncture, manual traditional acupuncture and sham acupuncture and undergo an eight-week intervention, then will be followed up for 8 weeks. Fibroid size, uterine arteries’ resistance index, pulsatility index, and diameter; Uterine Fibroid Symptoms and Health-Related Quality of Life (UFS-QOL) questionnaire scores, and adverse events will be compared before and immediately after the intervention, and after 8 weeks follow-up. The outcomes will be reported as statistically significant at a probability level of P value < 0.05.
Results
The results of this protocol will be published in peer-reviewed journals.
Conclusion
This clinical trial will be the first to provide substantial evidence regarding the safety and efficacy of acupuncture in the treatment of uterine fibroids, while also suggesting a mechanism through the analysis of uterine artery indices. Moreover, evaluating the differences in efficacy between segmental and traditional manual acupuncture will further facilitate the optimization of acupuncture methods for uterine fibroids.
{"title":"Acupuncture for uterine fibroids: A protocol for a randomized controlled trial comparing segmental electroacupuncture, manual acupuncture, and sham acupuncture","authors":"Elham Hooshyarazar , Parvaneh layegh , Leili Hafizi , Maliheh Dadgarmoghaddam , Sandro Graca , Amir Hooman Kazemi , Seyed Kazem Farahmand , Farnoosh Bidouee , Hoda Azizi","doi":"10.1016/j.eujim.2026.102614","DOIUrl":"10.1016/j.eujim.2026.102614","url":null,"abstract":"<div><h3>Introduction</h3><div>Uterine fibroids are prevalent among women of reproductive age. They have a negative impact on females' private and social life. As surgical and non-surgical approaches lead to some shortcomings such as reproduction failure, recurrence, and adverse effects of medications, complementary and integrative treatments have gained attention. Acupuncture is used for uterine fibroids in practice; however, the evidence is limited. This study aims to compare the effects of segmental electroacupuncture, manual acupuncture, and sham acupuncture on symptoms, mass size, and Doppler indices of uterine arteries in patients with uterine fibroids.</div></div><div><h3>Methods</h3><div>This study is a three-arm, sham-controlled, parallel-group, single-blinded, randomized clinical trial. Seventy-two cases with uterine fibroids type 1-6 according to the International Federation of Gynecology and Obstetrics classification will enter the study. They will be randomized into 3 groups, segmental electroacupuncture, manual traditional acupuncture and sham acupuncture and undergo an eight-week intervention, then will be followed up for 8 weeks. Fibroid size, uterine arteries’ resistance index, pulsatility index, and diameter; Uterine Fibroid Symptoms and Health-Related Quality of Life (UFS-QOL) questionnaire scores, and adverse events will be compared before and immediately after the intervention, and after 8 weeks follow-up. The outcomes will be reported as statistically significant at a probability level of P value < 0.05.</div></div><div><h3>Results</h3><div>The results of this protocol will be published in peer-reviewed journals.</div></div><div><h3>Conclusion</h3><div>This clinical trial will be the first to provide substantial evidence regarding the safety and efficacy of acupuncture in the treatment of uterine fibroids, while also suggesting a mechanism through the analysis of uterine artery indices. Moreover, evaluating the differences in efficacy between segmental and traditional manual acupuncture will further facilitate the optimization of acupuncture methods for uterine fibroids.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"83 ","pages":"Article 102614"},"PeriodicalIF":1.7,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.eujim.2026.102611
Hongsheng Liu , Qi Yang , Guiyuan Pang , Meiyu Huang , Lianxiang Lu , Peiyuan Li , Ben Chen , Lini Huo
Introduction
Network pharmacology is widely used to study the mechanisms of Traditional Chinese Medicine (TCM). However, existing methods do not account for the varying dosages of individual components in TCM formulas, which can affect result reliability. This study aimed to assess the impact of incorporating dosage information into network pharmacology for more accurate evaluation of TCM formulas.
Methods
A quantitative network pharmacology approach was developed by introducing the ‘Score of Quantitative Network Pharmacology’ (SQNP) as an evaluation index. Using Ma Huang Tang (MHT) as a case study, both qualitative and quantitative network pharmacology methods were applied to analyse key targets, Gene Ontology (GO) biological function enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The effects of dosage weighting were compared across both methods.
Results
The comparative analysis revealed that the quantitative method significantly improved the accuracy of identifying key targets. The top 10 targets were consistent in type but showed a significant change in ranking with the addition of dosage weighting. Biological function and pathway enrichment analysis also demonstrated higher reliability with the quantitative approach. The quantitative network pharmacology method provided a more comprehensive understanding of the therapeutic mechanisms of MHT.
Conclusions
Incorporating dosage information into network pharmacology using the SQNP method enhances the reliability of target identification and biological analysis for TCM formulas, offering a more accurate and scientifically robust evaluation for TCM research.
{"title":"Development of a quantitative network pharmacology approach for TCM formulas: A case study of Ma Huang Tang","authors":"Hongsheng Liu , Qi Yang , Guiyuan Pang , Meiyu Huang , Lianxiang Lu , Peiyuan Li , Ben Chen , Lini Huo","doi":"10.1016/j.eujim.2026.102611","DOIUrl":"10.1016/j.eujim.2026.102611","url":null,"abstract":"<div><h3>Introduction</h3><div>Network pharmacology is widely used to study the mechanisms of Traditional Chinese Medicine (TCM). However, existing methods do not account for the varying dosages of individual components in TCM formulas, which can affect result reliability. This study aimed to assess the impact of incorporating dosage information into network pharmacology for more accurate evaluation of TCM formulas.</div></div><div><h3>Methods</h3><div>A quantitative network pharmacology approach was developed by introducing the ‘Score of Quantitative Network Pharmacology’ (SQNP) as an evaluation index. Using Ma Huang Tang (MHT) as a case study, both qualitative and quantitative network pharmacology methods were applied to analyse key targets, Gene Ontology (GO) biological function enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The effects of dosage weighting were compared across both methods.</div></div><div><h3>Results</h3><div>The comparative analysis revealed that the quantitative method significantly improved the accuracy of identifying key targets. The top 10 targets were consistent in type but showed a significant change in ranking with the addition of dosage weighting. Biological function and pathway enrichment analysis also demonstrated higher reliability with the quantitative approach. The quantitative network pharmacology method provided a more comprehensive understanding of the therapeutic mechanisms of MHT.</div></div><div><h3>Conclusions</h3><div>Incorporating dosage information into network pharmacology using the SQNP method enhances the reliability of target identification and biological analysis for TCM formulas, offering a more accurate and scientifically robust evaluation for TCM research.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102611"},"PeriodicalIF":1.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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