European Journal of Integrative Medicine最新文献

{"title":"Traditional Chinese medicine external therapies for treating gastrointestinal dysfunction in sepsis: A network meta-analysis","authors":"Chunping Zheng,&nbsp;Luan Huang,&nbsp;Lijuan Tang,&nbsp;Chunbo Wu,&nbsp;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}

{"title":"A systematic review evaluating the quality of Ayurveda smartphone applications (Android)","authors":"Pooja Rani ,&nbsp;Neha Chauhan ,&nbsp;Sumit Kalra ,&nbsp;Ashutosh Ravi Gupta ,&nbsp;Sachin Singh ,&nbsp;Richard David ,&nbsp;Neetha RB ,&nbsp;Anandaraman PV","doi":"10.1016/j.eujim.2025.102606","DOIUrl":"10.1016/j.eujim.2025.102606","url":null,"abstract":"<div><h3>Introduction</h3><div>The convergence of traditional, complementary, and integrative medicine (TCIM) with contemporary digital health technologies presents a significant opportunity to expand the reach of affordable, evidence-based care. Ayurveda, a key discipline within TCIM, emphasises preventive strategies and lifestyle modifications for long-term health. However, the quality and relevance of mobile applications claiming to offer ayurvedic content remain largely unexamined, raising concerns regarding their efficacy and alignment with user needs.</div></div><div><h3>Objective</h3><div>This study aimed to systematically evaluate the content and quality of ayurveda-related mobile applications available on the Google Play Store (GPS). The present study also explored associations between app content, user ratings, with standardised quality scores to bring forth future directions.</div></div><div><h3>Methods</h3><div>A structured search was conducted in April 2024 using the most representative Ayurveda application-based keywords “Ayurveda,” “Ayurved,” and “AYUSH.” Eligible apps were screened to include those that were freely downloaded, non-duplicate, fully functional, and available in Hindi or English. Two trained reviewers independently evaluated apps using the validated Mobile Application Rating Scale (MARS). Correlation analyses were performed to examine the relationships between MARS scores, user ratings, and download counts.</div></div><div><h3>Results</h3><div>A total of 317 apps were retrieved from the GPS. After screening for duplicates and applying eligibility criteria, 145 applications were evaluated. Most of the apps belonged to the categories of e-books, e-magazines, herbal product shopping apps, coaching apps, home remedies and teleconsultation. The mean overall MARS score was 2.82 ± 0.69, while the app-specific value was 1.60 ± 0.63. Five apps scored &gt;4.0. Functionality achieved the highest rating (3.90 ± 0.57), followed by engagement (2.68 ± 0.75), aesthetics (2.60 ± 1.08), information (2.09 ± 0.54), and subjective quality (1.92 ± 0.62). Inter-rater reliability was high with Cronbach’s alpha at 0.935(95% C.I.). No significant correlation was observed between MARS scores, user ratings, and downloads (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The current landscape of ayurveda mobile applications lacks adherence to evidence-based content and usability, highlighting the need for collaborative, regulated development.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102606"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024082","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}

{"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 ,&nbsp;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> &lt; 0.001), attitude and practice (<em>r</em> = 0.295, <em>p</em> &lt; 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}

{"title":"Erratum to “Impact of acupuncture therapy on pregnancy outcome of patients with the first frozen-thawed embryo transfer: A retrospective cohort study” [European Journal of Integrative Medicine (2025) 102601]","authors":"Shu-Yuan Chen ,&nbsp;Yu-Quan Mao ,&nbsp;Yang-Ying Xu ,&nbsp;Duan Li ,&nbsp;Shan-Shan Li ,&nbsp;Miao Huang ,&nbsp;Yu-Jie Li ,&nbsp;Xue-Yu Wang ,&nbsp;Yu-Peng Jia ,&nbsp;Xiao-Wen Liu ,&nbsp;Cui-Fang Hao ,&nbsp;Xin Du","doi":"10.1016/j.eujim.2026.102610","DOIUrl":"10.1016/j.eujim.2026.102610","url":null,"abstract":"","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102610"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384810","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}

{"title":"The global impact of dry needling research: a bibliometric analysis of myofascial trigger point treatment from 1979 to 2024","authors":"Anas M. Alhakami ,&nbsp;Shakil Ahmed ,&nbsp;Nadeem Siddiqui ,&nbsp;Ali M. Alshami","doi":"10.1016/j.eujim.2025.102595","DOIUrl":"10.1016/j.eujim.2025.102595","url":null,"abstract":"<div><h3>Introduction</h3><div>Myofascial trigger points (MTrPs) are a common musculoskeletal feature, and dry needling (DN) has emerged as a popular non-pharmacological treatment for MTrPs since 1979. This study aimed to conduct a comprehensive bibliometric assessment of DN research on MTrPs.</div></div><div><h3>Methods</h3><div>We conducted a bibliometric analysis of publications on DN and MTrPs indexed in Scopus and Web of Science (1979–2024). After data cleaning and duplicate removal, two independent reviewers screened 833 records; inter-rater agreement was excellent (Cohen's κ ​= ​0.91). The final dataset of 618 documents was analysed using ScientoPY, Biblioshiny, and VOSviewer.</div></div><div><h3>Results</h3><div>We identified 618 publications (14,733 citations), with journal articles being the most common document type (487 publications, 10,067 citations). The annual output will peak in 2021 (72 publications). The USA (191 publications) and Spain (155 publications) have contributed equally. The University of Rey Juan Carlos (80 publications) and Fernández-de-las-Peñas (48 publications) were the most productive institutions and authors, respectively. The Journal of Bodywork and Movement Therapies published the most articles (n ​= ​62), whereas the Archives of Physical Medicine and Rehabilitation had the highest number of citations (961). Most DN studies were published in moderate-to-high-quality journals (Q1/Q2). The most cited study (Hong, 1994) compared DN with lidocaine injections. Predominant keywords included “dry needling”, “trigger point”, and “myofascial pain syndrome”. <em>Conclusions</em>: DN research on MTrPs has grown significantly, particularly in the USA and Spain, and appears predominantly in high-quality field-specific journals. To enhance the global visibility and impact, future studies should pursue multicentre trials, standardised protocols, cost-effectiveness, and broader geographic outreach.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"82 ","pages":"Article 102595"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384809","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}

{"title":"Antenatal yoga in Bangladesh: Pregnant women’s knowledge, attitudes, practices, and barriers to practice","authors":"Farhana Sultana Karim ,&nbsp;Satyapriya Maharana ,&nbsp;Sayeba Akhter ,&nbsp;Shahin Rahman Chowdhury ,&nbsp;Mangesh Pandey ,&nbsp;Rithika Keshav","doi":"10.1016/j.eujim.2025.102602","DOIUrl":"10.1016/j.eujim.2025.102602","url":null,"abstract":"<div><h3>Introduction</h3><div>Antenatal yoga (AY) promotes physical and mental well-being during pregnancy, yet evidence on AY knowledge, attitudes, practices, and barriers in Bangladesh is limited. Understanding these factors is essential for improving AY uptake in low-resource settings. This study investigated the knowledge, attitudes, practices, and barriers related to AY among pregnant women in Bangladesh and examined the influence of socio-demographic factors.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 502 pregnant women across Bangladesh using a standardized semi-structured questionnaire. Descriptive statistics, Chi-square tests, and multivariate logistic regression were performed. A multiple linear regression analysis was also conducted to identify predictors of overall AY knowledge.</div></div><div><h3>Results</h3><div>Awareness of AY was low (32.5 %), attitudes were moderately positive (32.9 %), and actual practice was very limited (4.6 %). The internet was the primary information source (32.7 %), and lack of information was the most commonly reported barrier (78.4 %). Education was strongly associated with adequate knowledge (OR = 2.10, 95 % CI [1.45, 3.05], <em>p</em> &lt; .001), and women who believed that AY reduces gestational diabetes mellitus (GDM) had higher knowledge (OR = 3.84, 95 % CI [2.60, 5.65], <em>p</em> &lt; .001). Multiple linear regression showed that education, belief in AY’s metabolic benefits, type of family, lack of information, and lack of time significantly predicted AY knowledge (<em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>AY knowledge and practice remain low among pregnant Bangladeshi women despite positive attitudes. Convenience sampling and self-reported data limit generalizability. Limited information, lack of guidance, and minimal access to trained instructors restrict AY uptake. Strengthening AY education, integrating guidance into antenatal care, and providing culturally appropriate online and offline resources may enhance adoption and improve maternal health outcomes.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"81 ","pages":"Article 102602"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920935","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}

{"title":"Effect of emotional freedom techniques on anxiety, surgical fear and birth perception in planned caesareans: A randomised controlled trial","authors":"Esra Karatas Okyay ,&nbsp;Sinem Guven Santur ,&nbsp;Zeliha Özsahin ,&nbsp;Yeşim Aksoy Derya","doi":"10.1016/j.eujim.2025.102584","DOIUrl":"10.1016/j.eujim.2025.102584","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to determine the effect of emotional freedom techniques (EFT) applied before cesarean section on anxiety, surgical fear and perception of traumatic birth.</div></div><div><h3>Method</h3><div>This randomized controlled trial was conducted with 106 pregnant women (53 EFT, 53 control) at the pregnancy outpatient clinic of a public hospital in eastern Türkiye who were going to give birth by planned cesarean section. Personal Information Form, State Anxiety Inventory (STAI-I), Surgical Fear Scale (SFQ), Traumatic Birth Perception Scale (TBPS) and Subjective Experiences Scale (SUE) were used to obtain the data. Pregnant women in the experimental group received two EFT sessions one week apart, from the researchers. The control group did not receive any intervention. Descriptive statistics, Pearson chi-square test, t-test for dependent and independent groups, ANCOVA and repeated measures analysis of variance were used to analyze the data.</div></div><div><h3>Results</h3><div>It was determined that the mean scores of the pregnant women in the experimental and control groups who would give birth by planned cesarean section were similar in the pretest phase (p &gt; 0.05). After the EFT sessions applied to the pregnant women in the experimental group, it was found that the mean total scores of STAI-I, SFQ, and TBPS were statistically significantly lower and the mean SUE score was higher than the control group (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>It was determined that EFT applied to pregnant women who will give birth by planned cesarean section decreased state anxiety, surgical fear and traumatic birth perception.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"81 ","pages":"Article 102584"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681591","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}

{"title":"Impact of acupuncture therapy on pregnancy outcome of patients with the first frozen-thawed embryo transfer: A retrospective cohort study","authors":"Shu-Yuan Chen ,&nbsp;Yu-Quan Mao ,&nbsp;Yang-Ying Xu ,&nbsp;Duan Li ,&nbsp;Shan-Shan Li ,&nbsp;Miao Huang ,&nbsp;Yu-Jie Li ,&nbsp;Xue-Yu Wang ,&nbsp;Yu-Peng Jia ,&nbsp;Xiao-Wen Liu ,&nbsp;Cui-Fang Hao ,&nbsp;Xin Du","doi":"10.1016/j.eujim.2025.102601","DOIUrl":"10.1016/j.eujim.2025.102601","url":null,"abstract":"<div><h3>Introduction</h3><div>Acupuncture therapy has been widely used as a complementary and alternative treatment for frozen-thawed embryo transfer (FET) procedures in clinical practice worldwide. Herein, we aimed to evaluate the impact of acupuncture therapy on the pregnancy outcomes in patients undergoing their first FET and to identify the population most responsive to acupuncture.</div></div><div><h3>Methods</h3><div>This retrospective cohort analysis included clinical data from 2830 patients who underwent their first cycle of FET at the Reproductive Medicine Center of Women and Children's Hospital, affiliated with Qingdao University, from March 2021 to March 2024. Patients were divided into a control group undergoing routine FET without acupuncture (<em>n</em> = 1085) and an acupuncture group receiving routine FET plus acupuncture performed before and after the transfer day (<em>n</em> = 1745). Generalized linear and binary logistic regression models were used to analyze and adjust for potential confounding factors to evaluate the effect of acupuncture on pregnancy outcomes between the two groups.</div></div><div><h3>Results</h3><div>The clinical pregnancy rate and implantation rate in the acupuncture group were higher than those in the control group (54.56 % vs. 48.85 %; adjusted odds ratios [aOR]=1.184, 95 % confidence interval [CI] = 1.011–1.387; <em>p</em> = 0.036; and 43.59 % vs. 39.17 %; aOR=0.034, 95 %CI=1.011–1.387; <em>p</em> = 0.045). There was no significant difference in the biochemical pregnancy rate, miscarriage rate, or live birth rate between the two groups (all <em>p</em> &gt; 0.05). Stratified analysis showed that acupuncture increased the likelihood of clinical pregnancy (aOR=1.225, 95 %CI=1.001–1.499; <em>p</em> = 0.048) in women &lt;35 years, but had no effect in women ≥35 years. Acupuncture was associated with a higher implantation rate (aOR=1.053, 95 %CI=1.013–1.095; <em>p</em> = 0.009), clinical pregnancy (aOR=1.256, 95 %CI=1.054–1.496; <em>p</em> = 0.011), and biochemical pregnancy (aOR=1.229, 95 %CI=1.025–1.473; <em>p</em> = 0.026) in women with normal ovarian reserve function, but showed no significant effect in those with decreased ovarian reserve function.</div></div><div><h3>Conclusion</h3><div>Acupuncture therapy can improve the implantation rate and clinical pregnancy rate in the first cycle of FET, and appears more beneficial in women &lt;35 years and those with normal ovarian reserve function, without associated adverse effects, indicating high safety. Nonetheless, more high-quality multicenter prospective randomized controlled trials are needed to further confirm these findings.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"81 ","pages":"Article 102601"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836856","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}

{"title":"East Asian herbal medicine as an add-on to antipsychotics in schizophrenia spectrum disorders accompanied by agitation: a systematic review and meta-analysis","authors":"Chan-Young Kwon ,&nbsp;Ji-Won Kim ,&nbsp;Ji-Won Oh ,&nbsp;Hye-Li Jeon ,&nbsp;Min-Jae Kim ,&nbsp;Kyoung-Eun Lee ,&nbsp;Boram Lee ,&nbsp;Pyung-Wha Kim ,&nbsp;Yujin Choi","doi":"10.1016/j.eujim.2025.102583","DOIUrl":"10.1016/j.eujim.2025.102583","url":null,"abstract":"<div><h3>Introduction</h3><div>Agitation is a frequent and disrupting symptom of schizophrenia spectrum disorders (SSDs) that can be difficult to manage with antipsychotic treatment alone. East Asian herbal medicine has been explored as a complementary therapy, but its effectiveness remains unclear. This review aimed to evaluate the effectiveness and safety of East Asian herbal medicine as an add-on therapy to antipsychotics compared to antipsychotics alone in the management of agitation in patients with SSDs.</div></div><div><h3>Methods</h3><div>Ten sources including eight databases (PubMed, EMBASE, CENTRAL, CNKI, CiNii, KISS, ScienceON, OASIS) and two additional sources (WHO ICTRP, JSOM website) were searched to January 2025. Randomized controlled trials (RCTs) comparing East Asian herbal medicine added to antipsychotics with antipsychotics alone in patients with SSDs accompanied by agitation were included. The primary outcome was the agitation symptoms measured using standardized scales (CMAI, PANSS-EC, or BPRS-EC), where lower scores indicate reduced agitation. Random-effects meta-analyses were performed. Risk of bias was evaluated using Cochrane RoB 2. The certainty of evidence for each outcome was assessed using the GRADE approach.</div></div><div><h3>Results</h3><div>Seven RCTs (n = 639) were included. Meta-analysis showed that East Asian herbal medicine added to antipsychotics significantly improved agitation symptoms (SMD −0.88 [95 % CI −1.26, −0.49]; I²=74 %), reduced adverse events (RR 0.44 [95 % CI 0.34, 0.57]; I²=0 %), and improved overall schizophrenia symptoms (SMD −1.99 [95 % CI −3.11, −0.86]; I²=68 %). Risk of bias was assessed as “some concerns” in all studies, mainly because of absence of allocation concealment reporting, placebo controls, and pre-registered protocols. Certainty of evidence was rated as moderate for agitation (downgraded for risk of bias) and low for secondary outcomes (downgraded for risk of bias and imprecision).</div></div><div><h3>Conclusions</h3><div>East Asian herbal medicine may improve agitation and reduce adverse events in SSDs when combined with antipsychotics. Large effect sizes warrant caution regarding potential small-study effects and methodological limitations. Future research should use rigorous double-blind placebo-controlled designs, standardized formulations, extended follow-ups, and diverse populations.</div></div><div><h3>Registration</h3><div>Protocol of this review was registered via PROSPERO (CRD42025643106)</div></div><div><h3>Funding</h3><div>Ministry of Health &amp; Welfare, Republic of Korea [grant number RS-2024-00442840]</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"81 ","pages":"Article 102583"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536861","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}

{"title":"Rethinking “Evidence” in Traditional Medicine “Integration”","authors":"Amandine Nachtergael ,&nbsp;Katrin Solhdju","doi":"10.1016/j.eujim.2025.102603","DOIUrl":"10.1016/j.eujim.2025.102603","url":null,"abstract":"<div><div>This paper explores the concept of integration of traditional medicine through a multidisciplinary approach that combines medical humanities and pharmaceutical sciences. While it aligns with the World Health Organization’s (WHO) objective of fostering a harmonious and functional coexistence between conventional medicine and other therapeutic practices to ensure optimal patient care, this paper critically examines the underlying rationale of the WHO’s strategy for achieving this integration. This logic is best illustrated by two of the central concepts that structure the WHO’s discourse on T&amp;CM<span><span>¹</span></span>: Integration and Evidence-Based. Both inform research-funding decisions, most notably in the cooperation for development sector, and have a decisive influence on public health policies. In most parts of the world, the necessity for an evidence-based integration of T&amp;CM functions like a mantra, rarely questioned by researchers within the medical or the social sciences, or by governmental and non-governmental actors. Consequently, the present paper problematizes the “evidence-based integration” of “traditional” medicines by challenging some of the key assumptions underpinning these concepts. In doing so, it aims to identify and highlight several elements that may serve as guides on the way to ethically and epistemologically more sound frameworks for the co-existence of modern and traditional medicines.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"81 ","pages":"Article 102603"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920940","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}