Pub Date : 2025-10-24DOI: 10.1016/j.eujim.2025.102573
Catrina Davy , Michael Loughlin , John Hughes
Introduction
Ten sessions of acupuncture are recommended in the UK National Institute for Health and Care Excellence guidelines for the prophylactic treatment of migraines. However, ongoing or maintenance treatment is not recommended. Teaching people self-acupuncture (SA) may help people to manage their migraines. To date, there is no research examining SA in the management of migraines.
Methods
This study will examine the feasibility of all aspects of a trial of SA for patients who have previously found acupuncture beneficial to manage their migraines. This will include preliminary data on the size of any effect, participants’ views on the trial design and intervention, and any safety issues. The findings will determine the methodology for a subsequent RCT to examine the efficacy of SA to treat migraines.
The trial will employ a pragmatic, mixed-methods, randomised, parallel-group, exploratory design. The trial will compare SA plus standard care versus standard care alone. The trial aims to recruit 60 participants: 40 randomised to the SA group and 20 to the standard care group. Participants will be eligible if they have had a course of at least six acupuncture sessions to manage their migraines at the Royal London Hospital for Integrated Medicine, UK and found the treatments effective. Participants will complete outcome measures at various time points and take part in a qualitative interview to explore their views on the design of the trial and acceptability of SA. The researcher will observe and take field notes of the teaching session to explore the acceptability of the SA teaching method. Data will be analysed to determine if the trial design is feasible.
{"title":"A study protocol for a randomised feasibility trial of self-acupuncture for patients with migraines (SAM)","authors":"Catrina Davy , Michael Loughlin , John Hughes","doi":"10.1016/j.eujim.2025.102573","DOIUrl":"10.1016/j.eujim.2025.102573","url":null,"abstract":"<div><h3>Introduction</h3><div>Ten sessions of acupuncture are recommended in the UK National Institute for Health and Care Excellence guidelines for the prophylactic treatment of migraines. However, ongoing or maintenance treatment is not recommended. Teaching people self-acupuncture (SA) may help people to manage their migraines. To date, there is no research examining SA in the management of migraines.</div></div><div><h3>Methods</h3><div>This study will examine the feasibility of all aspects of a trial of SA for patients who have previously found acupuncture beneficial to manage their migraines. This will include preliminary data on the size of any effect, participants’ views on the trial design and intervention, and any safety issues. The findings will determine the methodology for a subsequent RCT to examine the efficacy of SA to treat migraines.</div><div>The trial will employ a pragmatic, mixed-methods, randomised, parallel-group, exploratory design. The trial will compare SA plus standard care versus standard care alone. The trial aims to recruit 60 participants: 40 randomised to the SA group and 20 to the standard care group. Participants will be eligible if they have had a course of at least six acupuncture sessions to manage their migraines at the Royal London Hospital for Integrated Medicine, UK and found the treatments effective. Participants will complete outcome measures at various time points and take part in a qualitative interview to explore their views on the design of the trial and acceptability of SA. The researcher will observe and take field notes of the teaching session to explore the acceptability of the SA teaching method. Data will be analysed to determine if the trial design is feasible.</div></div><div><h3>Trial registration information</h3><div>ClinicalTrials.gov <span><span>https://clinicaltrials.gov/study/NCT06716944?cond=migraine&intr=acupuncture&rank=1</span><svg><path></path></svg></span> NCT06716944</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102573"},"PeriodicalIF":1.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145413563","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 : 2025-10-20DOI: 10.1016/j.eujim.2025.102571
Chaohui Yan , Xi Luo , Yiwen Tang, Hong Chen, Shiting Qin, Yumei Huang, Chunhui Zeng, Ke Yang
Background
Novel, effective, and safe therapeutic strategies are urgently needed to overcome conventional acute lung injury (ALI) treatment limitations. This study combined network pharmacology and experimental verification to explore the relationship between Ampelopsin (APS) and ALI molecular pathways, and to elucidate the key mechanism of APS in attenuating ALI.
Methods
The Swiss Target Prediction, Traditional Chinese Medicine Systems Pharmacology, DisGeNET, and GeneCards databases were used to predict the targets of APS to attenuate ALI. Potential targets were imported into the Metascape database to perform protein-protein interaction network, Gene ontology, and Kyoto encyclopedia of genes and genomes analyses, and a “drug - target - disease - access network” was established. Molecular docking of APS with key targets was performed using PyMOL and AutoDock. Validation experiments were performed using a lipopolysaccharide (LPS)-induced ALI mouse model, LPS-induced inflammatory A549 cells, and molecular docking between active compounds of APS and potential targets.
Results
Network pharmacology analysis identified six key targets (AKT1, AKT2, epidermal growth factor receptor, HRAS, IGF1R, and KDR) of APS to attenuate ALI, which were mainly involved in biological processes, such as cell migration and movement, regulation of kinase activity, and PI3K-Akt signaling pathway. Molecular docking analysis revealed that APS binds the key targets with binding energy ranging from -4.37 to -2.26. Further experiments revealed that APS could reduce pulmonary edema by reducing inflammatory factor release and regulate oxidative stress and autophagy, thus protecting LPS-induced ALI mice and A549 cells.
Conclusions
APS regulates inflammation and oxidative stress via the PI3K-Akt signaling pathway, thus retarding ALI progression.
{"title":"Ampelopsin's mechanism in ameliorating acute lung injury: Insights from network pharmacology and experimental validation","authors":"Chaohui Yan , Xi Luo , Yiwen Tang, Hong Chen, Shiting Qin, Yumei Huang, Chunhui Zeng, Ke Yang","doi":"10.1016/j.eujim.2025.102571","DOIUrl":"10.1016/j.eujim.2025.102571","url":null,"abstract":"<div><h3>Background</h3><div>Novel, effective, and safe therapeutic strategies are urgently needed to overcome conventional acute lung injury (ALI) treatment limitations. This study combined network pharmacology and experimental verification to explore the relationship between Ampelopsin (APS) and ALI molecular pathways, and to elucidate the key mechanism of APS in attenuating ALI.</div></div><div><h3>Methods</h3><div>The Swiss Target Prediction, Traditional Chinese Medicine Systems Pharmacology, DisGeNET, and GeneCards databases were used to predict the targets of APS to attenuate ALI. Potential targets were imported into the Metascape database to perform protein-protein interaction network, Gene ontology, and Kyoto encyclopedia of genes and genomes analyses, and a “drug - target - disease - access network” was established. Molecular docking of APS with key targets was performed using PyMOL and AutoDock. Validation experiments were performed using a lipopolysaccharide (LPS)-induced ALI mouse model, LPS-induced inflammatory A549 cells, and molecular docking between active compounds of APS and potential targets.</div></div><div><h3>Results</h3><div>Network pharmacology analysis identified six key targets (AKT1, AKT2, epidermal growth factor receptor, HRAS, IGF1R, and KDR) of APS to attenuate ALI, which were mainly involved in biological processes, such as cell migration and movement, regulation of kinase activity, and PI3K-Akt signaling pathway. Molecular docking analysis revealed that APS binds the key targets with binding energy ranging from -4.37 to -2.26. Further experiments revealed that APS could reduce pulmonary edema by reducing inflammatory factor release and regulate oxidative stress and autophagy, thus protecting LPS-induced ALI mice and A549 cells.</div></div><div><h3>Conclusions</h3><div>APS regulates inflammation and oxidative stress via the PI3K-Akt signaling pathway, thus retarding ALI progression.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102571"},"PeriodicalIF":1.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145413564","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 : 2025-10-18DOI: 10.1016/j.eujim.2025.102572
Jiashan Li , Yuning Qin , Liyun He , Feifei Gao , Ziyan Li , Tingting Liu , Zezhi Fan , Yi Guo , Tianyi Zhao , Xue Zhao
Introduction
Patients with atrophic gastritis (AG) exhibit typical upper gastrointestinal symptoms. Although acupuncture therapy can alleviate some gastrointestinal symptoms, it remains challenging to determine the optimal intervention for various symptoms. This study aimed to use network meta-analysis (NMA) to compare the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms.
Methods
Twelve databases were systematically searched from inception to 25 November 2024 to identify randomized clinical trials or retrospective cohort studies that evaluated the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms. The primary outcomes were stomachache, flatulence, heartburn, hiccups, and appetite disorder (assessed using the traditional Chinese medicine syndrome score, numeric rating scale or visual analogue score), and acid reflux (assessed using the symptom score). The Cochrane Risk of Bias 2 tool was used to construct a risk-of-bias map. R 4.3.2 and JAGS 4.3.1 were used to conduct the NMA. The Confidence in NMA web application was used to assess the quality of evidence.
Results
The NMA analyzed 26 studies involving 3,076 participants. For flatulence, acupoint sticking therapy was ranked first (i.e., most effective), with a surface under the cumulative ranking curve (SUCRA) of 83.2 %, and low to very low certainty. Manual acupuncture was ranked first for acid reflux (SUCRA 87.19 %, low to very low certainty) and appetite disorder (SUCRA 67.5 %, moderate to very low certainty). Warm acupuncture plus traditional Chinese medicine was ranked first for stomachache (SUCRA 75.0 %, low to very low certainty), while western medicine was ranked first for hiccups (SUCRA 91.93 %, very low certainty). There were no significant differences in efficacy between many acupuncture therapies.
Conclusion
Patients with AG with flatulence may benefit from acupoint sticking therapy, while the symptoms of acid reflux or appetite disorder may be relieved through manual acupuncture. However, clinical decision-making should be combined with practical factors due to the limited number of significant differences in the efficacy of various acupuncture therapies.
{"title":"Acupuncture therapy for atrophic gastritis with upper gastrointestinal symptoms: A systematic review and network meta-analysis","authors":"Jiashan Li , Yuning Qin , Liyun He , Feifei Gao , Ziyan Li , Tingting Liu , Zezhi Fan , Yi Guo , Tianyi Zhao , Xue Zhao","doi":"10.1016/j.eujim.2025.102572","DOIUrl":"10.1016/j.eujim.2025.102572","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with atrophic gastritis (AG) exhibit typical upper gastrointestinal symptoms. Although acupuncture therapy can alleviate some gastrointestinal symptoms, it remains challenging to determine the optimal intervention for various symptoms. This study aimed to use network meta-analysis (NMA) to compare the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms.</div></div><div><h3>Methods</h3><div>Twelve databases were systematically searched from inception to 25 November 2024 to identify randomized clinical trials or retrospective cohort studies that evaluated the efficacy of acupuncture therapies for AG with upper gastrointestinal symptoms. The primary outcomes were stomachache, flatulence, heartburn, hiccups, and appetite disorder (assessed using the traditional Chinese medicine syndrome score, numeric rating scale or visual analogue score), and acid reflux (assessed using the symptom score). The Cochrane Risk of Bias 2 tool was used to construct a risk-of-bias map. R 4.3.2 and JAGS 4.3.1 were used to conduct the NMA. The Confidence in NMA web application was used to assess the quality of evidence.</div></div><div><h3>Results</h3><div>The NMA analyzed 26 studies involving 3,076 participants. For flatulence, acupoint sticking therapy was ranked first (i.e., most effective), with a surface under the cumulative ranking curve (SUCRA) of 83.2 %, and low to very low certainty. Manual acupuncture was ranked first for acid reflux (SUCRA 87.19 %, low to very low certainty) and appetite disorder (SUCRA 67.5 %, moderate to very low certainty). Warm acupuncture plus traditional Chinese medicine was ranked first for stomachache (SUCRA 75.0 %, low to very low certainty), while western medicine was ranked first for hiccups (SUCRA 91.93 %, very low certainty). There were no significant differences in efficacy between many acupuncture therapies.</div></div><div><h3>Conclusion</h3><div>Patients with AG with flatulence may benefit from acupoint sticking therapy, while the symptoms of acid reflux or appetite disorder may be relieved through manual acupuncture. However, clinical decision-making should be combined with practical factors due to the limited number of significant differences in the efficacy of various acupuncture therapies.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102572"},"PeriodicalIF":1.7,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358807","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 : 2025-10-14DOI: 10.1016/j.eujim.2025.102570
Thang Truong Le , Tien-Dung Nguyen , Minh-Thuong Nguyen-Van , Tran Ngo Bao Huynh , Thuan-Thien Dinh , Chau Dao Minh Huynh , Phuc Dao Thien Nguyen , Tan Nguyen Van Ho , Hieu Tran-Van , Viet Hoang
Introduction
Candida albicans (C. albicans) infections pose a significant health challenge, necessitating the exploration of novel antifungal agents. Essential oils derived from medicinal plants play a crucial role in aromatherapy as a complementary therapeutic approach. This study aimed to investigate the molecular mechanisms of Melaleuca bracteata F. Mueall (M. bracteata) essential oil against C. albicans, establishing its potential as a novel plant-derived antifungal therapeutic in response to increasing antimicrobial resistance.
Methods
This study employed a comprehensive approach, combining chemical analysis, in vitro experiments, and computational methods to investigate the antifungal properties of M. bracteata essential oil against C. albicans.
Results
Gas Chromatography-Mass Spectrometry (GCMS) analysis revealed eugenol methyl ether (EME) as the predominant component (86.87 %) of M. bracteata essential oil. The oil demonstrated potent antifungal activity against C. albicans, with a Minimum Inhibitory Concentration (MIC) of 400 µg/mL. It significantly inhibited biofilm formation, with 96.03 % inhibition at MIC, and caused notable morphological changes in C. albicans cells as observed through Scanning Electron Microscope (SEM). Gene expression analysis showed the downregulation of key biofilm-related genes (efg1, als3, act1) upon treatment with the oil. Molecular docking suggested potential interactions of EME with critical C. albicans proteins. Importantly, the oil exhibited limited cytotoxicity against various mammalian cell lines. Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) predictions indicated favorable pharmacokinetic properties for EME, while network pharmacology analysis suggested potential immunomodulatory effects.
Conclusions
These findings highlight the promising antifungal potential of M. bracteata essential oil, particularly EME, against C. albicans, warranting further investigation for its development as a novel therapeutic agent.
白色念珠菌（C. albicans）感染对健康构成重大挑战，需要探索新的抗真菌药物。从药用植物中提取的精油作为一种辅助治疗方法在芳香疗法中起着至关重要的作用。本研究旨在探讨白念珠菌（C. alaleuca bracteata F. Mueall， M. bracteata）精油抗白色念珠菌的分子机制，确定其作为一种新型植物源性抗真菌药物的潜力，以应对日益增加的抗生素耐药性。方法采用化学分析、体外实验和计算方法相结合的综合研究方法，研究苞叶分枝杆菌精油对白色念珠菌的抑菌作用。结果气相色谱-质谱（GCMS）分析显示，丁香酚甲醚（EME）为主要成分，占86.87%。该精油对白色念珠菌具有较强的抑菌活性，最低抑菌浓度（MIC）为400µg/mL。通过扫描电镜（SEM）观察，其显著抑制了生物膜的形成，MIC抑制率为96.03%，并引起白色念珠菌细胞形态的明显改变。基因表达分析显示，油处理后，关键生物膜相关基因（efg1, als3, act1）表达下调。分子对接提示EME可能与关键的白色念珠菌蛋白相互作用。重要的是，该油对多种哺乳动物细胞系显示出有限的细胞毒性。吸收、分布、代谢、排泄和毒性（ADMET）预测表明EME具有良好的药代动力学特性，而网络药理学分析表明EME具有潜在的免疫调节作用。结论这些研究结果表明，短苞草精油，特别是EME，对白色念珠菌具有良好的抗真菌潜力，值得进一步研究，以开发其作为一种新的治疗药物。
{"title":"Antifungal mechanisms of Melaleuca bracteata F. Mueall essential oil against Candida albicans: From chemical profiling to molecular targets","authors":"Thang Truong Le , Tien-Dung Nguyen , Minh-Thuong Nguyen-Van , Tran Ngo Bao Huynh , Thuan-Thien Dinh , Chau Dao Minh Huynh , Phuc Dao Thien Nguyen , Tan Nguyen Van Ho , Hieu Tran-Van , Viet Hoang","doi":"10.1016/j.eujim.2025.102570","DOIUrl":"10.1016/j.eujim.2025.102570","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Candida albicans (C. albicans)</em> infections pose a significant health challenge, necessitating the exploration of novel antifungal agents. Essential oils derived from medicinal plants play a crucial role in aromatherapy as a complementary therapeutic approach. This study aimed to investigate the molecular mechanisms of <em>Melaleuca bracteata</em> F. Mueall <em>(M. bracteata)</em> essential oil against <em>C. albicans</em>, establishing its potential as a novel plant-derived antifungal therapeutic in response to increasing antimicrobial resistance.</div></div><div><h3>Methods</h3><div>This study employed a comprehensive approach, combining chemical analysis, <em>in vitro</em> experiments, and computational methods to investigate the antifungal properties of <em>M. bracteata</em> essential oil against <em>C. albicans</em>.</div></div><div><h3>Results</h3><div>Gas Chromatography-Mass Spectrometry (GCMS) analysis revealed eugenol methyl ether (EME) as the predominant component (86.87 %) of <em>M. bracteata</em> essential oil. The oil demonstrated potent antifungal activity against <em>C. albicans</em>, with a Minimum Inhibitory Concentration (MIC) of 400 µg/mL. It significantly inhibited biofilm formation, with 96.03 % inhibition at MIC, and caused notable morphological changes in <em>C. albicans</em> cells as observed through Scanning Electron Microscope (SEM). Gene expression analysis showed the downregulation of key biofilm-related genes (<em>efg1, als3, act1</em>) upon treatment with the oil. Molecular docking suggested potential interactions of EME with critical <em>C. albicans</em> proteins. Importantly, the oil exhibited limited cytotoxicity against various mammalian cell lines. Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) predictions indicated favorable pharmacokinetic properties for EME, while network pharmacology analysis suggested potential immunomodulatory effects.</div></div><div><h3>Conclusions</h3><div>These findings highlight the promising antifungal potential of <em>M. bracteata</em> essential oil, particularly EME, against <em>C. albicans</em>, warranting further investigation for its development as a novel therapeutic agent.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102570"},"PeriodicalIF":1.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145359469","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 : 2025-10-08DOI: 10.1016/j.eujim.2025.102569
Vibhuti Samarth Rao , Birinder S Cheema , Mike Armour , Caroline A Smith , Kashinath G Metri , Carolyn Ee
Introduction
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age and is associated with excess weight. Yoga is a holistic mind-body practice that has shown some promise in targeting clinical outcomes in women with PCOS. This study aimed to understand the yoga therapists’ experiences and explore the characteristics of a yoga therapy (YT) program for weight management in women with Polycystic Ovary Syndrome (PCOS) to assist in a future trial.
Methods
Experienced yoga therapists with a degree in yoga, or equivalent, and >5 years of experience in delivering yoga to women with PCOS were invited to an online focus group. Discussions were audio-recorded, transcribed verbatim and analysed using descriptive content analysis.
Results
Eight yoga therapists participated. Four categories with several sub-categories were derived from the analysis: (i) yogic approach to PCOS management, (ii) benefits are beyond weight reduction, (iii) characteristics of yoga therapists, and (iv) characteristics of the YT program for managing weight in PCOS. Most participants believe that YT for PCOS should not be constructed as an exclusive form of exercise but as a mind-body intervention that focuses on lifestyle reforms, helps manage day-to-day stress, and promotes sleep and quality of life in women with PCOS. Overall, the participants indicated that a meticulously planned group-based, multicomponent, PCOS-specific, YT class can be a sustainable mode of healthy living for women with PCOS.
Conclusion
This is the first qualitative exploration from yoga therapists’ perspectives on weight management in women with PCOS. The results of this study provide a valuable preliminary basis for the design of future research in order to enhance lifestyle care for women with PCOS and excess weight.
{"title":"Yoga for weight management in women with polycystic ovary syndrome: A focus group study among yoga therapists","authors":"Vibhuti Samarth Rao , Birinder S Cheema , Mike Armour , Caroline A Smith , Kashinath G Metri , Carolyn Ee","doi":"10.1016/j.eujim.2025.102569","DOIUrl":"10.1016/j.eujim.2025.102569","url":null,"abstract":"<div><h3>Introduction</h3><div>Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age and is associated with excess weight. Yoga is a holistic mind-body practice that has shown some promise in targeting clinical outcomes in women with PCOS. This study aimed to understand the yoga therapists’ experiences and explore the characteristics of a yoga therapy (YT) program for weight management in women with Polycystic Ovary Syndrome (PCOS) to assist in a future trial.</div></div><div><h3>Methods</h3><div>Experienced yoga therapists with a degree in yoga, or equivalent, and >5 years of experience in delivering yoga to women with PCOS were invited to an online focus group. Discussions were audio-recorded, transcribed verbatim and analysed using descriptive content analysis.</div></div><div><h3>Results</h3><div>Eight yoga therapists participated. Four categories with several sub-categories were derived from the analysis: (i) yogic approach to PCOS management, (ii) benefits are beyond weight reduction, (iii) characteristics of yoga therapists, and (iv) characteristics of the YT program for managing weight in PCOS. Most participants believe that YT for PCOS should not be constructed as an exclusive form of exercise but as a mind-body intervention that focuses on lifestyle reforms, helps manage day-to-day stress, and promotes sleep and quality of life in women with PCOS. Overall, the participants indicated that a meticulously planned group-based, multicomponent, PCOS-specific, YT class can be a sustainable mode of healthy living for women with PCOS.</div></div><div><h3>Conclusion</h3><div>This is the first qualitative exploration from yoga therapists’ perspectives on weight management in women with PCOS. The results of this study provide a valuable preliminary basis for the design of future research in order to enhance lifestyle care for women with PCOS and excess weight.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102569"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270030","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 : 2025-10-02DOI: 10.1016/j.eujim.2025.102568
Soo-Hyun Sung , Kyeong-Han Kim , Hyein Jeong , Soobin Jang
Introduction
Many older adults and individuals with disabilities experience significant barriers to accessing clinic-based health services, often resulting in unmanaged chronic conditions and diminished quality of life. Home-based healthcare is emerging as a viable solution, and interest in traditional Korean medicine is increasing due to its accessibility and perceived safety. This study aimed to identify the needs and expectations of older adults and individuals with disabilities for home-based healthcare using traditional Korean medicine.
Methods
Our study employed a mixed methods design that combined survey data and qualitative research. The online survey was conducted among two groups: 1) older adults aged 65 years and older and 2) individuals with disabilities aged 20 years and older. Semi-structured focus group interviews were conducted for the respondents who received home visits from traditional Korean medicine doctors
Results
Survey findings revealed that older adults showed a higher demand and willingness to participate in home-based healthcare services than individuals with disabilities. Respondents identified chronic conditions such as hypertension, diabetes, stroke, and dementia as key targets for home-based care. High-priority needs included physical and mental health support, health monitoring, and integration with conventional medical services. The most valued benefit of home-based care was improved accessibility for those with difficulty visiting hospitals. Focus group interview participants, particularly older adults, described feeling psychologically supported and satisfied through extended health counseling provided during house calls. Individuals with disabilities emphasized the need for transportation support for follow-up hospital visits.
Conclusions
Our findings provide foundational evidence for the development of integrated, home-based healthcare policies targeting older adults and people with disabilities. Expanding home-based traditional Korean medicine care may address health inequities and enhance well-being among populations with limited mobility.
{"title":"Understanding the demands for home-based healthcare services using traditional Korean medicine in older adults and individuals with disabilities: A mixed methods study","authors":"Soo-Hyun Sung , Kyeong-Han Kim , Hyein Jeong , Soobin Jang","doi":"10.1016/j.eujim.2025.102568","DOIUrl":"10.1016/j.eujim.2025.102568","url":null,"abstract":"<div><h3>Introduction</h3><div>Many older adults and individuals with disabilities experience significant barriers to accessing clinic-based health services, often resulting in unmanaged chronic conditions and diminished quality of life. Home-based healthcare is emerging as a viable solution, and interest in traditional Korean medicine is increasing due to its accessibility and perceived safety. This study aimed to identify the needs and expectations of older adults and individuals with disabilities for home-based healthcare using traditional Korean medicine.</div></div><div><h3>Methods</h3><div>Our study employed a mixed methods design that combined survey data and qualitative research. The online survey was conducted among two groups: 1) older adults aged 65 years and older and 2) individuals with disabilities aged 20 years and older. Semi-structured focus group interviews were conducted for the respondents who received home visits from traditional Korean medicine doctors</div></div><div><h3>Results</h3><div>Survey findings revealed that older adults showed a higher demand and willingness to participate in home-based healthcare services than individuals with disabilities. Respondents identified chronic conditions such as hypertension, diabetes, stroke, and dementia as key targets for home-based care. High-priority needs included physical and mental health support, health monitoring, and integration with conventional medical services. The most valued benefit of home-based care was improved accessibility for those with difficulty visiting hospitals. Focus group interview participants, particularly older adults, described feeling psychologically supported and satisfied through extended health counseling provided during house calls. Individuals with disabilities emphasized the need for transportation support for follow-up hospital visits.</div></div><div><h3>Conclusions</h3><div>Our findings provide foundational evidence for the development of integrated, home-based healthcare policies targeting older adults and people with disabilities. Expanding home-based traditional Korean medicine care may address health inequities and enhance well-being among populations with limited mobility.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102568"},"PeriodicalIF":1.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325652","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 : 2025-10-01DOI: 10.1016/j.eujim.2025.102547
Gahena Ram , Rotina Kapini , Xian Zhou
Introduction
Australia has some of the highest rates of sun-related skin damage in the world. Native Australian flora is known to possess unique phytochemical profiles with potential protective effects against such damage. The Kakadu Plum (Terminalia ferdinandiana Exell), traditionally utilized by Indigenous Australians, is notable for its exceptionally high concentrations of vitamin C and diverse phenolic compounds. This scoping review aims to synthesise the available evidence regarding the efficacy of Kakadu Plum as a topical intervention for the primary prevention of photodamage.
Methods
The methodology was guided by the JBI Manual for Evidence Synthesis, and the reporting was guided by the PRISMA Extension for Scoping Reviews. A comprehensive search was conducted across multiple databases, including MEDLINE, PubMed, Embase, Scopus, Google Scholar, and the Agriculture Science Database, to gather direct and indirect data on Kakadu Plum's photoprotective potential and vitamin C concentrations over the past 20 years (2005–2025).
Results
A total of 31 preclinical studies were found. Only 1 study directly examined Kakadu Plum's photoprotective effect in an animal model, 22 studies provided evidence of indirect photoprotective mechanisms, including antioxidant and anti-inflammatory effects, and 8 studies exclusively reported on the vitamin C content.
Conclusion
The results demonstrated exceptionally high vitamin C concentrations, providing strong indirect evidence of Kakadu Plum's potential photoprotective effect. However, the absence of direct experimental or clinical evidence precludes definitive conclusions regarding its efficacy. Kakadu Plum, therefore, may be an underexplored natural resource, warranting further research into its photoprotective mechanisms and therapeutic potential.
Funding
Dr. Xian Zhou is supported by the Research Support Fellowship, Western Sydney University.
{"title":"Examining the potential of terminalisa ferdinandiana Exell (Kakadu Plum) in photoprotection through direct and indirect evidence: A scoping review","authors":"Gahena Ram , Rotina Kapini , Xian Zhou","doi":"10.1016/j.eujim.2025.102547","DOIUrl":"10.1016/j.eujim.2025.102547","url":null,"abstract":"<div><h3>Introduction</h3><div>Australia has some of the highest rates of sun-related skin damage in the world. Native Australian flora is known to possess unique phytochemical profiles with potential protective effects against such damage. The Kakadu Plum (<em>Terminalia ferdinandiana</em> Exell), traditionally utilized by Indigenous Australians, is notable for its exceptionally high concentrations of vitamin C and diverse phenolic compounds. This scoping review aims to synthesise the available evidence regarding the efficacy of Kakadu Plum as a topical intervention for the primary prevention of photodamage.</div></div><div><h3>Methods</h3><div>The methodology was guided by the JBI Manual for Evidence Synthesis, and the reporting was guided by the PRISMA Extension for Scoping Reviews. A comprehensive search was conducted across multiple databases, including MEDLINE, PubMed, Embase, Scopus, Google Scholar, and the Agriculture Science Database, to gather direct and indirect data on Kakadu Plum's photoprotective potential and vitamin C concentrations over the past 20 years (2005–2025).</div></div><div><h3>Results</h3><div>A total of 31 preclinical studies were found. Only 1 study directly examined Kakadu Plum's photoprotective effect in an animal model, 22 studies provided evidence of indirect photoprotective mechanisms, including antioxidant and anti-inflammatory effects, and 8 studies exclusively reported on the vitamin C content.</div></div><div><h3>Conclusion</h3><div>The results demonstrated exceptionally high vitamin C concentrations, providing strong indirect evidence of Kakadu Plum's potential photoprotective effect. However, the absence of direct experimental or clinical evidence precludes definitive conclusions regarding its efficacy. Kakadu Plum, therefore, may be an underexplored natural resource, warranting further research into its photoprotective mechanisms and therapeutic potential.</div></div><div><h3>Funding</h3><div>Dr. Xian Zhou is supported by the Research Support Fellowship, <span>Western Sydney University</span>.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102547"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265517","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 : 2025-09-24DOI: 10.1016/j.eujim.2025.102561
Bingrui Zhang , Kebin Wang , Yuxiao Li , Qinhua Fan , Qingxiao Li , Yingqiu Sun , Yawei Du , Wenquan Su , Shengxian Wu
Introduction
Astragalus membranaceus (AM) is a traditional Chinese medicine employed for supplementing qi and particularly used for ulcer treatment. This systematic review aimed to examine the effectiveness and safety of AM-based prescriptions (AMPs) for diabetic foot ulcer (DFU).
Methods
We searched eight databases to identify randomized controlled trials (RCTs) focusing on AMPs for DFU. The mean difference (MD) and relative risk (RR) with 95% confidence interval (CI) were calculated and used in the meta-analysis.
Results
We included 44 RCTs involving 3,238 participants. The AMPs included 24 oral AM formulas, 14 topical AM formulas, 4 topical AM alone, and 2 injections. Overall, study quality was low. Compared with Western medicine (WM), AMPs were associated with a higher healing rate (RR 1.64, 95% CI 1.4 to 1.9, 8 RCTs, n = 747), smaller ulcer size (MD –12.11 cm2, 95% CI –19.23 to –4.99, 4 RCTs, n = 304) and shorter healing time (MD –7.82 days, 95% CI –10.59 to –5.05, 4 RCTs, n = 353). AMPs plus WM were more efficacious than WM in healing rate (RR 1.22, 95% CI 1.07 to 1.4, 20 RCTs, n = 1497), amputation rate (RR 0.42, 95% CI 0.27 to 0.66, 3 RCTs, n = 265), mortality (RR 0.29, 95% CI 0.12 to 0.71, 3 RCTs, n = 265), ulcer size (MD –1.78 cm2, 95% CI –2.55 to –1.01, 10 RCTs, n = 761), healing time, ankle-brachial index (ABI), pain scores, clinical effective rate, and general symptoms. No severe adverse events were reported in the AMPs group.
Conclusion
AMPs may have potential effectiveness in ulcer healing, ABI increase, and pain alleviation. The exact efficacy of AMPs for DFU needs to be confirmed using high-quality double-blind RCTs.
Registration
Protocol of this review was registered via PROSPERO (CRD42024613403).
Funding
National Science and Technology Major Project of China [grant number 2017ZX09304019].
黄芪（astragalus aceus， AM）是一种传统的补气中药，特别用于治疗溃疡。本系统综述旨在研究AMPs治疗糖尿病足溃疡（DFU）的有效性和安全性。方法我们检索了8个数据库，以AMPs治疗DFU为重点的随机对照试验（rct）。计算具有95%置信区间（CI）的平均差值（MD）和相对危险度（RR）并用于meta分析。结果纳入44项随机对照试验，涉及3238名受试者。amp包括24个口服AM制剂、14个外用AM制剂、4个单独外用AM制剂和2个注射剂。总体而言，研究质量较低。与西药（WM）相比，AMPs具有更高的治愈率（RR 1.64, 95% CI 1.4 ~ 1.9, 8个rct， n = 747）、更小的溃疡面积（MD -12.11 cm2, 95% CI -19.23 ~ -4.99, 4个rct， n = 304）和更短的愈合时间（MD -7.82天，95% CI -10.59 ~ -5.05, 4个rct， n = 353）。AMPs加WM在治愈率（RR 1.22, 95% CI 1.07 ~ 1.4, 20个rct， n = 1497）、截肢率（RR 0.42, 95% CI 0.27 ~ 0.66, 3个rct， n = 265）、死亡率（RR 0.29, 95% CI 0.12 ~ 0.71, 3个rct， n = 265）、溃疡大小（MD -1.78 cm2, 95% CI -2.55 ~ -1.01, 10个rct， n = 761）、愈合时间、踝臂指数（ABI）、疼痛评分、临床有效率和一般症状等方面均优于WM。amp组无严重不良事件报告。结论抗菌肽对溃疡愈合、增加ABI、减轻疼痛具有潜在的作用。AMPs治疗DFU的确切疗效需要通过高质量的双盲随机对照试验来证实。本综述的注册方案通过PROSPERO注册（CRD42024613403）。国家科技重大专项[批准号：2017ZX09304019]。
{"title":"Effectiveness and safety of Astragalus membranaceus-based traditional Chinese medicine in treating diabetic foot ulcers: A systematic review and meta-analysis of randomized controlled trials","authors":"Bingrui Zhang , Kebin Wang , Yuxiao Li , Qinhua Fan , Qingxiao Li , Yingqiu Sun , Yawei Du , Wenquan Su , Shengxian Wu","doi":"10.1016/j.eujim.2025.102561","DOIUrl":"10.1016/j.eujim.2025.102561","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Astragalus membranaceus</em> (AM) is a traditional Chinese medicine employed for supplementing qi and particularly used for ulcer treatment. This systematic review aimed to examine the effectiveness and safety of AM-based prescriptions (AMPs) for diabetic foot ulcer (DFU).</div></div><div><h3>Methods</h3><div>We searched eight databases to identify randomized controlled trials (RCTs) focusing on AMPs for DFU. The mean difference (MD) and relative risk (RR) with 95% confidence interval (CI) were calculated and used in the meta-analysis.</div></div><div><h3>Results</h3><div>We included 44 RCTs involving 3,238 participants. The AMPs included 24 oral AM formulas, 14 topical AM formulas, 4 topical AM alone, and 2 injections. Overall, study quality was low. Compared with Western medicine (WM), AMPs were associated with a higher healing rate (RR 1.64, 95% CI 1.4 to 1.9, 8 RCTs, n = 747), smaller ulcer size (MD –12.11 cm<sup>2</sup>, 95% CI –19.23 to –4.99, 4 RCTs, n = 304) and shorter healing time (MD –7.82 days, 95% CI –10.59 to –5.05, 4 RCTs, n = 353). AMPs plus WM were more efficacious than WM in healing rate (RR 1.22, 95% CI 1.07 to 1.4, 20 RCTs, n = 1497), amputation rate (RR 0.42, 95% CI 0.27 to 0.66, 3 RCTs, n = 265), mortality (RR 0.29, 95% CI 0.12 to 0.71, 3 RCTs, n = 265), ulcer size (MD –1.78 cm<sup>2</sup>, 95% CI –2.55 to –1.01, 10 RCTs, n = 761), healing time, ankle-brachial index (ABI), pain scores, clinical effective rate, and general symptoms. No severe adverse events were reported in the AMPs group.</div></div><div><h3>Conclusion</h3><div>AMPs may have potential effectiveness in ulcer healing, ABI increase, and pain alleviation. The exact efficacy of AMPs for DFU needs to be confirmed using high-quality double-blind RCTs.</div></div><div><h3>Registration</h3><div>Protocol of this review was registered via PROSPERO (CRD42024613403).</div></div><div><h3>Funding</h3><div><span>National Science and Technology Major Project of China</span> [grant number <span><span>2017ZX09304019</span></span>].</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102561"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183678","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 : 2025-09-22DOI: 10.1016/j.eujim.2025.102560
Shih-Wei Yang , Chen-Wei Chang , Malcolm Koo
Introduction
Heart Rate Variability (HRV), a noninvasive marker of autonomic nervous system function, has become an increasingly utilized tool in complementary medicine (CM) research for objectively assessing physiological responses to interventions. While specific applications of HRV within individual CM modalities have been reviewed, comprehensive mapping of the broader research landscape remains limited. This bibliometric study aimed to provide a detailed overview of the evolution, key contributors, and thematic development of HRV research across diverse CM interventions between 2005 and 2024.
Methods
Original research articles published between January 1, 2005, and December 31, 2024, were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. A Boolean search strategy combined HRV-related terms with keywords representing a wide range of CM interventions, while deliberately excluding broad or ambiguous descriptors. The data were analyzed using the Bibliometrix package.
Results
A total of 1007 articles published across 375 journals and authored by 4969 individuals were identified, with publication output showing a steady increase and peaking in 2022. China (23.5%) and the United States (19.1%) emerged as the most prolific contributors, although United States publications exhibited a higher average citation rate. Leading institutions included Kyung Hee University (South Korea) and China Medical University (Taiwan). Evidence-Based Complementary and Alternative Medicine was the most frequent publishing journal. HRV and CM research has increasingly appeared in higher-ranked journals over time (p < 0.001). Keyword co-occurrence analysis positioned HRV as a central term, connecting clusters related to mind-body practices, psychophysiological constructs, music therapy, and electroacupuncture. Thematic evolution analysis revealed recent trends toward greater methodological rigor, increased emphasis on patient-centered outcomes, diversification of CM interventions, and incorporation of emerging digital health technologies.
Conclusion
This bibliometric analysis shows HRV research in CM as an evolving field positioned at the intersection of traditional practices, contemporary physiological science, and technological innovation. Recent trends indicate a shift toward increased methodological rigor, greater emphasis on patient-centered outcomes, and integration of digital technologies. As the field advances, novel technologies such as generative artificial intelligence offer promise for deepening physiological insights and enhancing the clinical relevance of CM applications within mainstream healthcare.
心率变异性（HRV）是一种自主神经系统功能的无创标志物，已成为补充医学（CM）研究中越来越多地使用的工具，用于客观评估对干预的生理反应。虽然已经审查了HRV在个体CM模式中的具体应用，但对更广泛的研究前景的全面绘制仍然有限。本文献计量学研究旨在提供2005年至2024年间不同CM干预措施中HRV研究的演变、关键贡献者和主题发展的详细概述。方法检索2005年1月1日至2024年12月31日发表的论文，检索Web of Science核心馆藏的科学引文索引扩展版。布尔搜索策略将hrv相关术语与代表广泛CM干预的关键字结合起来，同时故意排除宽泛或模糊的描述符。使用Bibliometrix软件包对数据进行分析。结果在375个期刊上共发现1007篇论文，作者4969人，发表量稳步增长，并在2022年达到峰值。中国（23.5%）和美国（19.1%）成为最多产的贡献者，尽管美国出版物的平均引用率更高。以证据为基础的补充和替代医学是出版频率最高的期刊。随着时间的推移，HRV和CM研究越来越多地出现在排名较高的期刊上（p < 0.001）。关键词共现分析将HRV定位为中心术语，将与身心实践、心理生理结构、音乐治疗和电针相关的集群联系起来。专题演变分析揭示了最近的趋势，即方法更加严谨，更加强调以患者为中心的结果，CM干预的多样化以及新兴数字卫生技术的结合。文献计量学分析表明，CM中的HRV研究是一个不断发展的领域，处于传统实践、当代生理科学和技术创新的交叉点。最近的趋势表明，越来越多的方法变得严谨，更加强调以患者为中心的结果，以及数字技术的整合。随着该领域的发展，生成式人工智能等新技术为深化生理学见解和增强主流医疗保健中CM应用的临床相关性提供了希望。
{"title":"Mapping the intersection of heart rate variability and complementary medicine: a two-decade bibliometric study (2005–2024)","authors":"Shih-Wei Yang , Chen-Wei Chang , Malcolm Koo","doi":"10.1016/j.eujim.2025.102560","DOIUrl":"10.1016/j.eujim.2025.102560","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart Rate Variability (HRV), a noninvasive marker of autonomic nervous system function, has become an increasingly utilized tool in complementary medicine (CM) research for objectively assessing physiological responses to interventions. While specific applications of HRV within individual CM modalities have been reviewed, comprehensive mapping of the broader research landscape remains limited. This bibliometric study aimed to provide a detailed overview of the evolution, key contributors, and thematic development of HRV research across diverse CM interventions between 2005 and 2024.</div></div><div><h3>Methods</h3><div>Original research articles published between January 1, 2005, and December 31, 2024, were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. A Boolean search strategy combined HRV-related terms with keywords representing a wide range of CM interventions, while deliberately excluding broad or ambiguous descriptors. The data were analyzed using the Bibliometrix package.</div></div><div><h3>Results</h3><div>A total of 1007 articles published across 375 journals and authored by 4969 individuals were identified, with publication output showing a steady increase and peaking in 2022. China (23.5%) and the United States (19.1%) emerged as the most prolific contributors, although United States publications exhibited a higher average citation rate. Leading institutions included Kyung Hee University (South Korea) and China Medical University (Taiwan). <em>Evidence-Based Complementary and Alternative Medicine</em> was the most frequent publishing journal. HRV and CM research has increasingly appeared in higher-ranked journals over time (<em>p</em> < 0.001). Keyword co-occurrence analysis positioned HRV as a central term, connecting clusters related to mind-body practices, psychophysiological constructs, music therapy, and electroacupuncture. Thematic evolution analysis revealed recent trends toward greater methodological rigor, increased emphasis on patient-centered outcomes, diversification of CM interventions, and incorporation of emerging digital health technologies.</div></div><div><h3>Conclusion</h3><div>This bibliometric analysis shows HRV research in CM as an evolving field positioned at the intersection of traditional practices, contemporary physiological science, and technological innovation. Recent trends indicate a shift toward increased methodological rigor, greater emphasis on patient-centered outcomes, and integration of digital technologies. As the field advances, novel technologies such as generative artificial intelligence offer promise for deepening physiological insights and enhancing the clinical relevance of CM applications within mainstream healthcare.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102560"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154514","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 : 2025-09-20DOI: 10.1016/j.eujim.2025.102555
Gyu Chan Shim , Sook-Hyun Lee , Yoon Jae Lee , Su Won Lee , In-Hyuk Ha
Introduction
Low back pain (LBP) is a major cause of disability and economic burden. Herbal medicine (HM) decoctions, a core component of Traditional East Asian Medicine (TEAM), are gaining attention for their potential benefits. This systematic review evaluated HM decoctions for LBP.
Methods
The protocol was registered in PROSPERO (CRD42024599753). Eleven databases were searched for randomized controlled trials (RCTs) on HM decoctions for LBP published before July 2024. Primary outcomes were the clinical improvement rate (CIR) and visual analogue scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index and the Japanese Orthopedic Association scale. Quality assessments using the Cochrane Risk of Bias 2 tool and meta-analyses were conducted.
Results
Twenty-nine RCTs involving 2420 participants with LBP were included. HM decoction compared to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the CIR (risk ratio [RR] 1.16, 95 %CI: 1.05 to 1.29) and reduced VAS-pain (mean difference [MD] -0.87, 95 %CI: -1.59 to -0.14). When combined with TEAM, HM decoction improved the CIR (RR, 1.23, 95 %CI: 1.14 to 1.33) and VAS-pain (MD -1.24, 95 %CI: -1.80 to -0.67) compared to TEAM alone. The combination of HM decoction and TEAM improved the CIR (RR 1.25, 95 %CI: 1.01 to 1.55) and VAS-pain (MD -0.51, 95 %CI: -0.67 to -0.34) compared to NSAIDs alone, and a higher CIR (RR 1.30, 95 %CI: 1.12 to 1.52) than TEAM combined with NSAIDs. Combining HM decoction with NSAIDs improved the CIR (RR 1.48, 95 %CI: 1.19 to 1.85) compared to NSAIDs alone; however, there was no difference in VAS-pain (MD -1.09, 95 %CI: -2.35 to 0.17). HM decoction combined with non-pharmacological therapies (NPTs) improved the CIR (RR 1.18, 95 %CI: 1.05 to 1.32) and VAS-pain (MD -1.28, 95 %CI: -1.42 to -1.14). Finally, adding HM decoction to a regimen of NSAIDs and NPTs also improved the CIR (RR 1.24, 95 %CI: 1.09 to 1.42, but the reduction in VAS-pain was not statistically significant (MD -1.53, 95 %CI: -3.35 to -0.29).. In the seven RCTs that reported adverse events, these were absent or mild and comparable across intervention and control groups.
Conclusion
HM decoction demonstrated beneficial clinical effects for participants with LBP. Limitations included high risk of bias in many RCTs. Well-designed RCTs are warranted to validate effectiveness.
{"title":"Effects of traditional east asian herbal medicine decoctions on low back pain: A systematic review and meta-analysis","authors":"Gyu Chan Shim , Sook-Hyun Lee , Yoon Jae Lee , Su Won Lee , In-Hyuk Ha","doi":"10.1016/j.eujim.2025.102555","DOIUrl":"10.1016/j.eujim.2025.102555","url":null,"abstract":"<div><h3>Introduction</h3><div>Low back pain (LBP) is a major cause of disability and economic burden. Herbal medicine (HM) decoctions, a core component of Traditional East Asian Medicine (TEAM), are gaining attention for their potential benefits. This systematic review evaluated HM decoctions for LBP.</div></div><div><h3>Methods</h3><div>The protocol was registered in PROSPERO (CRD42024599753). Eleven databases were searched for randomized controlled trials (RCTs) on HM decoctions for LBP published before July 2024. Primary outcomes were the clinical improvement rate (CIR) and visual analogue scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index and the Japanese Orthopedic Association scale. Quality assessments using the Cochrane Risk of Bias 2 tool and meta-analyses were conducted.</div></div><div><h3>Results</h3><div>Twenty-nine RCTs involving 2420 participants with LBP were included. HM decoction compared to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the CIR (risk ratio [RR] 1.16, 95 %CI: 1.05 to 1.29) and reduced VAS-pain (mean difference [MD] -0.87, 95 %CI: -1.59 to -0.14). When combined with TEAM, HM decoction improved the CIR (RR, 1.23, 95 %CI: 1.14 to 1.33) and VAS-pain (MD -1.24, 95 %CI: -1.80 to -0.67) compared to TEAM alone. The combination of HM decoction and TEAM improved the CIR (RR 1.25, 95 %CI: 1.01 to 1.55) and VAS-pain (MD -0.51, 95 %CI: -0.67 to -0.34) compared to NSAIDs alone, and a higher CIR (RR 1.30, 95 %CI: 1.12 to 1.52) than TEAM combined with NSAIDs. Combining HM decoction with NSAIDs improved the CIR (RR 1.48, 95 %CI: 1.19 to 1.85) compared to NSAIDs alone; however, there was no difference in VAS-pain (MD -1.09, 95 %CI: -2.35 to 0.17). HM decoction combined with non-pharmacological therapies (NPTs) improved the CIR (RR 1.18, 95 %CI: 1.05 to 1.32) and VAS-pain (MD -1.28, 95 %CI: -1.42 to -1.14). Finally, adding HM decoction to a regimen of NSAIDs and NPTs also improved the CIR (RR 1.24, 95 %CI: 1.09 to 1.42, but the reduction in VAS-pain was not statistically significant (MD -1.53, 95 %CI: -3.35 to -0.29).. In the seven RCTs that reported adverse events, these were absent or mild and comparable across intervention and control groups.</div></div><div><h3>Conclusion</h3><div>HM decoction demonstrated beneficial clinical effects for participants with LBP. Limitations included high risk of bias in many RCTs. Well-designed RCTs are warranted to validate effectiveness.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102555"},"PeriodicalIF":1.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270028","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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