Pub Date : 2025-12-18DOI: 10.1016/j.imr.2025.101283
Arya Nielsen , Natalie L. Dyer , Kiran Faryar , Jeffery A. Dusek
Acupuncture has been used for millennia to treat pain and in recent decades included as an evidence-based strategy for comprehensive pain care. More recently, acupuncture has also been used to treat acute peri‑operative pain and acute pain in the Emergency department (ED). While there are models of acupuncture’s effect on chronic pain, the lack of application of those models for acute pain represents a gap in our scientific understanding.
Acupuncture in the ED is a single-session dose intervention. In the context of clarifying significant details of an acupuncture intervention including needle insertion, needle perturbation (to obtain de qi), and needle retention, point specificity, adequate dose using local and distal acupoints, and functional MRI (fMRI) brain studies of acupuncture treatment for pain, a body and auricular model of acupuncture’s specific effects in acute pain reduction is presented. The biomechanisms of body acupuncture are shown to be an interaction between local physiological responses at a needling site and peripheral and central analgesic responses. An auricular model conceptualizes how stimulation of the auricular branch of the vagus nerve also modulates autonomic and central nervous systems. Nonspecific effects of acupuncture are also discussed.
The purpose of this review is to illustrate the biomechanisms of acupuncture for acute pain as a complex intervention that integrates patterns of change at physiological and molecular levels that can inform existing and future effectiveness research and facilitate assimilation of acupuncture in the ED.
{"title":"Therapeutic mechanisms of acupuncture therapy for acute pain in the emergency department","authors":"Arya Nielsen , Natalie L. Dyer , Kiran Faryar , Jeffery A. Dusek","doi":"10.1016/j.imr.2025.101283","DOIUrl":"10.1016/j.imr.2025.101283","url":null,"abstract":"<div><div>Acupuncture has been used for millennia to treat pain and in recent decades included as an evidence-based strategy for comprehensive pain care. More recently, acupuncture has also been used to treat acute peri‑operative pain and acute pain in the Emergency department (ED). While there are models of acupuncture’s effect on chronic pain, the lack of application of those models for acute pain represents a gap in our scientific understanding.</div><div>Acupuncture in the ED is a single-session dose intervention. In the context of clarifying significant details of an acupuncture intervention including needle insertion, needle perturbation (to obtain de qi), and needle retention, point specificity, adequate dose using local and distal acupoints, and functional MRI (fMRI) brain studies of acupuncture treatment for pain, a body and auricular model of acupuncture’s specific effects in acute pain reduction is presented. The biomechanisms of body acupuncture are shown to be an interaction between local physiological responses at a needling site and peripheral and central analgesic responses. An auricular model conceptualizes how stimulation of the auricular branch of the vagus nerve also modulates autonomic and central nervous systems. Nonspecific effects of acupuncture are also discussed.</div><div>The purpose of this review is to illustrate the biomechanisms of acupuncture for acute pain as a complex intervention that integrates patterns of change at physiological and molecular levels that can inform existing and future effectiveness research and facilitate assimilation of acupuncture in the ED.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101283"},"PeriodicalIF":3.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972675","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 : 2025-12-17DOI: 10.1016/j.imr.2025.101281
Zelei Dai , Xi Chen , Nian Li , Chenfeng Tan , Yonggang Zhang , Ying Wang , Renjie Zhao , Kefan Li , Mike Clarke , Lei Liu , Lingmin Chen
Background
Although many systematic reviews and meta-analyses have explored Traditional Chinese Medicine (TCM) for non-small cell lung carcinoma (NSCLC), uncertainty remains about the pooled efficacy, safety, and methodological quality of these reviews and the interventions they assessed. This study aimed to address this gap by analyzing TCM treatments for NSCLC using evidence mapping.
Methods
A comprehensive search across six databases identified relevant systematic reviews and meta-analyses up to August 2025. The AMSTAR-2 tool was used to assess methodological quality, and Python was used for statistical analysis and visualization. Evidence maps were created to group reviews by treatment types (chemotherapy, targeted therapy, radiotherapy, immunotherapy and supportive care) and by specific outcomes such as objective response rate (ORR), leukopenia, and quality of life (QoL).
Results
Out of 196 systematic reviews, 42 TCM interventions and 55 outcomes were identified. Most reviews examined TCM combined with chemotherapy, particularly Aidi, Kanglaite, and Shenqi Fuzheng injections. These combinations showed potential benefits in ORR, QoL, and chemotherapy-induced leukopenia. TCM combined with targeted therapies, such as EGFR-TKIs and Astragalus, also indicated benefits in progression-free survival and immune function. However, most systematic reviews were of "critically low" quality, limiting evidence reliability.
Conclusion
While TCM shows promise in enhancing conventional NSCLC treatments, high-quality, rigorously conducted randomised trials and reviews are essential to confirm these findings and guide clinical integration.
{"title":"Traditional Chinese medicine for non-small cell lung carcinoma: An evidence mapping","authors":"Zelei Dai , Xi Chen , Nian Li , Chenfeng Tan , Yonggang Zhang , Ying Wang , Renjie Zhao , Kefan Li , Mike Clarke , Lei Liu , Lingmin Chen","doi":"10.1016/j.imr.2025.101281","DOIUrl":"10.1016/j.imr.2025.101281","url":null,"abstract":"<div><h3>Background</h3><div>Although many systematic reviews and meta-analyses have explored Traditional Chinese Medicine (TCM) for non-small cell lung carcinoma (NSCLC), uncertainty remains about the pooled efficacy, safety, and methodological quality of these reviews and the interventions they assessed. This study aimed to address this gap by analyzing TCM treatments for NSCLC using evidence mapping.</div></div><div><h3>Methods</h3><div>A comprehensive search across six databases identified relevant systematic reviews and meta-analyses up to August 2025. The AMSTAR-2 tool was used to assess methodological quality, and Python was used for statistical analysis and visualization. Evidence maps were created to group reviews by treatment types (chemotherapy, targeted therapy, radiotherapy, immunotherapy and supportive care) and by specific outcomes such as objective response rate (ORR), leukopenia, and quality of life (QoL).</div></div><div><h3>Results</h3><div>Out of 196 systematic reviews, 42 TCM interventions and 55 outcomes were identified. Most reviews examined TCM combined with chemotherapy, particularly Aidi, Kanglaite, and Shenqi Fuzheng injections. These combinations showed potential benefits in ORR, QoL, and chemotherapy-induced leukopenia. TCM combined with targeted therapies, such as EGFR-TKIs and Astragalus, also indicated benefits in progression-free survival and immune function. However, most systematic reviews were of \"critically low\" quality, limiting evidence reliability.</div></div><div><h3>Conclusion</h3><div>While TCM shows promise in enhancing conventional NSCLC treatments, high-quality, rigorously conducted randomised trials and reviews are essential to confirm these findings and guide clinical integration.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101281"},"PeriodicalIF":3.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034675","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 : 2025-12-09DOI: 10.1016/j.imr.2025.101280
Anna Kim , Young Eun Kim , Sumin Seo , Sungha Kim , Eunbyul Cho , Yujeong Kang , Eunhee Lee , Mi Ju Son
Background
Herbal medicines (HMs) are commonly used during the postpartum period in South Korea; however, comprehensive data regarding their safety remain limited. This study aimed to evaluate the safety of HM use among postpartum women through the “SAFEty of HErbal medicine REgistry in Postpartum Care center” (SAFEHERE-PC) study.
Methods
A single-arm, prospective observational study was conducted from March to December 2024, enrolling 186 women within six weeks postpartum who were admitted to the postpartum care center of a Korean Medicine hospital. The study monitored adverse events (AEs) during HM use, collecting demographic information, medical history, herbal prescription details, and AE data. Reported AEs were analyzed using the WHO-UMC causality assessment and the Naranjo algorithm.
Results
Of the 186 participants, 4 (2.2 %) experienced AEs following HM administration, all of which were gastrointestinal symptoms (diarrhea, loose stools). Three of the five events were managed with a short course of the herbal formula, and two cases resolved spontaneously without requiring medical intervention. Based on severity and clinical course, the events were classified as mild to moderate. Causality assessment using the WHO-UMC system classified four cases as "possible" and one as "certain", while the Naranjo scale indicated three cases as "possible" and two as "probable" in their association with HM use.
Conclusion
A low incidence of mild gastrointestinal AEs (2.2 % of patients; 0.6 % of prescriptions) was observed, with no serious AEs reported. These findings provide descriptive safety data specific to the formulations and clinical practices used at this hospital-based postpartum care center.
Trial registration
Korean National Clinical Trial Registry Clinical Research Information Service: KCT0009060.
{"title":"Safety of herbal medicine in the postpartum period: A hospital-based single-arm, prospective observational study (SAFEHERE-PC)","authors":"Anna Kim , Young Eun Kim , Sumin Seo , Sungha Kim , Eunbyul Cho , Yujeong Kang , Eunhee Lee , Mi Ju Son","doi":"10.1016/j.imr.2025.101280","DOIUrl":"10.1016/j.imr.2025.101280","url":null,"abstract":"<div><h3>Background</h3><div>Herbal medicines (HMs) are commonly used during the postpartum period in South Korea; however, comprehensive data regarding their safety remain limited. This study aimed to evaluate the safety of HM use among postpartum women through the “SAFEty of HErbal medicine REgistry in Postpartum Care center” (SAFEHERE-PC) study.</div></div><div><h3>Methods</h3><div>A single-arm, prospective observational study was conducted from March to December 2024, enrolling 186 women within six weeks postpartum who were admitted to the postpartum care center of a Korean Medicine hospital. The study monitored adverse events (AEs) during HM use, collecting demographic information, medical history, herbal prescription details, and AE data. Reported AEs were analyzed using the WHO-UMC causality assessment and the Naranjo algorithm.</div></div><div><h3>Results</h3><div>Of the 186 participants, 4 (2.2 %) experienced AEs following HM administration, all of which were gastrointestinal symptoms (diarrhea, loose stools). Three of the five events were managed with a short course of the herbal formula, and two cases resolved spontaneously without requiring medical intervention. Based on severity and clinical course, the events were classified as mild to moderate. Causality assessment using the WHO-UMC system classified four cases as \"possible\" and one as \"certain\", while the Naranjo scale indicated three cases as \"possible\" and two as \"probable\" in their association with HM use.</div></div><div><h3>Conclusion</h3><div>A low incidence of mild gastrointestinal AEs (2.2 % of patients; 0.6 % of prescriptions) was observed, with no serious AEs reported. These findings provide descriptive safety data specific to the formulations and clinical practices used at this hospital-based postpartum care center.</div></div><div><h3>Trial registration</h3><div>Korean National Clinical Trial Registry Clinical Research Information Service: KCT0009060.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101280"},"PeriodicalIF":3.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034674","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 : 2025-11-26DOI: 10.1016/j.imr.2025.101279
Yongjoo Kim , Nan-He Yoon , Soobin Jang , Kyeore Bae , Wonkyung Moon , Minjung Park , Sujin Kim
Background
Herbal medicine decoctions (HMD) are potential treatments for Bell’s palsy (BP), but real-world evidence regarding the safety is limited. This study investigated whether HMD use for BP was associated with risk of adverse events using a nationwide claims-based database in South Korea.
Methods
This retrospective cohort study used data from the Korean Health Insurance Review and Assessment database. We applied coarsened exact matching, through which 1627 BP patients who received at least one HMD prescription between November 2020 and February 2022 were matched with 1627 BP patients who did not use HMD. Difference-in-differences logistic regression modeling compared the incidences of safety outcomes between HMD users and non-users.
Results
No significant differences were observed in the risk of hepatotoxicity, renal failure, allergic events, hospitalization, and emergency department visits between HMD users and non-users with BP, assessed at 3, 6, 9 and 11 months after HMD prescription. All effect estimates and corresponding 95 % confidence intervals included the null value.
Conclusions
There was no significant difference in the risk of safety outcomes between HMD users and non-users with BP. Further research is warranted to understand the safety of specific herbal formulas or individual herbs using broader safety measures.
{"title":"Safety of herbal medicine decoction for facial palsy: Coarsened exact matching analysis of the national health insurance database","authors":"Yongjoo Kim , Nan-He Yoon , Soobin Jang , Kyeore Bae , Wonkyung Moon , Minjung Park , Sujin Kim","doi":"10.1016/j.imr.2025.101279","DOIUrl":"10.1016/j.imr.2025.101279","url":null,"abstract":"<div><h3>Background</h3><div>Herbal medicine decoctions (HMD) are potential treatments for Bell’s palsy (BP), but real-world evidence regarding the safety is limited. This study investigated whether HMD use for BP was associated with risk of adverse events using a nationwide claims-based database in South Korea.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from the Korean Health Insurance Review and Assessment database. We applied coarsened exact matching, through which 1627 BP patients who received at least one HMD prescription between November 2020 and February 2022 were matched with 1627 BP patients who did not use HMD. Difference-in-differences logistic regression modeling compared the incidences of safety outcomes between HMD users and non-users.</div></div><div><h3>Results</h3><div>No significant differences were observed in the risk of hepatotoxicity, renal failure, allergic events, hospitalization, and emergency department visits between HMD users and non-users with BP, assessed at 3, 6, 9 and 11 months after HMD prescription. All effect estimates and corresponding 95 % confidence intervals included the null value.</div></div><div><h3>Conclusions</h3><div>There was no significant difference in the risk of safety outcomes between HMD users and non-users with BP. Further research is warranted to understand the safety of specific herbal formulas or individual herbs using broader safety measures.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101279"},"PeriodicalIF":3.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074091","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 : 2025-10-30DOI: 10.1016/j.imr.2025.101267
Sanghun Lee , Sunmi Choi
{"title":"Acupuncture electroceuticals: The convergence of traditional acupuncture theory and modern bioelectronic medicine","authors":"Sanghun Lee , Sunmi Choi","doi":"10.1016/j.imr.2025.101267","DOIUrl":"10.1016/j.imr.2025.101267","url":null,"abstract":"","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101267"},"PeriodicalIF":3.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576166","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 : 2025-10-13DOI: 10.1016/j.imr.2025.101265
Maria Benxia Wu , Yong-Kang Wu , Meng-Hua Chen , Benjamin Kimble , Brian May , Vincent Chan , Stella Stylianou , Bin Xu , Daniel Man-yuen Sze , Zhen Zheng
Background
Traditional Chinese medicine (TCM) tongue diagnosis entails the systematic evaluation of morphological characteristics (tongue features) on both dorsal and ventral tongue surfaces. Recent advancements in research have highlighted the potential diagnostic relevance of specific tongue features for cancer detection and monitoring through various inspection methodologies. This scoping review aims to provide a comprehensive overview of tongue features investigated in relation to cancer detection.
Methods
A literature search for clinical studies (excluding case reports) that examined the application of tongue inspection for detecting cancer, recurrence, or metastasis was conducted. Extracted data included study characteristics, patient populations, inspection techniques, and diagnostic outcomes.
Results
Twenty-four studies consisting of 14 case-control studies, 4 cross sectional studies, 5 observational study, and 1 prospective multicentred cohort were identified, involving a total of 5458 cancer patients and 7880 control participants. Documented tongue features included lingual flange protrusion, sublingual nodules, engorged sublingual veins, purple-bluish tongue, and variations in tongue coating thickness, etc. that were associated with different cancer types and metastasis. Using QUADAS-2, the overall quality was low with potentially high risk of bias in some key domains, especially participant selection and index test.
Conclusion
The findings from this review provide a foundation for future research questions aimed at high-level observational studies. Tongue inspection holds promise as a cost-effective, time-efficient, and non-invasive method for detecting cancers and metastasis. Based on quality assessment, the study highlights future needs such as more prospective, blinded interpretation, pre-specified thresholds, and transparent reporting to improve both methodological rigor and external validity.
{"title":"Exploring traditional Chinese medicine tongue diagnosis in potential cancer identification: A scoping review","authors":"Maria Benxia Wu , Yong-Kang Wu , Meng-Hua Chen , Benjamin Kimble , Brian May , Vincent Chan , Stella Stylianou , Bin Xu , Daniel Man-yuen Sze , Zhen Zheng","doi":"10.1016/j.imr.2025.101265","DOIUrl":"10.1016/j.imr.2025.101265","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Chinese medicine (TCM) tongue diagnosis entails the systematic evaluation of morphological characteristics (tongue features) on both dorsal and ventral tongue surfaces. Recent advancements in research have highlighted the potential diagnostic relevance of specific tongue features for cancer detection and monitoring through various inspection methodologies. This scoping review aims to provide a comprehensive overview of tongue features investigated in relation to cancer detection.</div></div><div><h3>Methods</h3><div>A literature search for clinical studies (excluding case reports) that examined the application of tongue inspection for detecting cancer, recurrence, or metastasis was conducted. Extracted data included study characteristics, patient populations, inspection techniques, and diagnostic outcomes.</div></div><div><h3>Results</h3><div>Twenty-four studies consisting of 14 case-control studies, 4 cross sectional studies, 5 observational study, and 1 prospective multicentred cohort were identified, involving a total of 5458 cancer patients and 7880 control participants. Documented tongue features included lingual flange protrusion, sublingual nodules, engorged sublingual veins, purple-bluish tongue, and variations in tongue coating thickness, etc. that were associated with different cancer types and metastasis. Using QUADAS-2, the overall quality was low with potentially high risk of bias in some key domains, especially participant selection and index test.</div></div><div><h3>Conclusion</h3><div>The findings from this review provide a foundation for future research questions aimed at high-level observational studies. Tongue inspection holds promise as a cost-effective, time-efficient, and non-invasive method for detecting cancers and metastasis. Based on quality assessment, the study highlights future needs such as more prospective, blinded interpretation, pre-specified thresholds, and transparent reporting to improve both methodological rigor and external validity.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101265"},"PeriodicalIF":3.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972673","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 : 2025-10-11DOI: 10.1016/j.imr.2025.101263
Lixia Yuan , Bofei Shu , Jieyi Zhou , Wenxi Li , Hui Wang , Xu Zhou
Background
Plant seeds constitute an important category of medicinal and edible herbs. However, assessments regarding their safety for human consumption remain insufficient. This systematic review comprehensively evaluates human safety for 21 medicinal and edible seeds.
Methods
Two independent reviewers screened the titles, abstracts, and fulltexts of the retrieved literature against the inclusion and exclusion criteria to identify eligible AE reports in both English (PubMed, Embase, CENTRAL) and Chinese (CNKI, Wanfang, VIP, SinoMed) databases. Search strategies were constructed using the scientific names, common names, and frequent aliases of the medicinal and edible seeds combined with safety evaluation keywords such as "adverse reaction," "toxicity," and "side effect." Any studies describing adverse event (AE) after human intake of specific seeds were included. AE characteristics were summarized. Causality between seed consumption and AEs was assessed.
Results
We identified 703 AEs involving eight medicinal and edible seeds. Ginkgo semen and Armeniacae semen amarum caused the most AEs, followed by Persicae semen, Myristicae semen, Sterculiae lychnophorae semen, Canavaliae semen, Cassiae semen, and Ziziphi spinosae semen. Among the AEs, 70.8% occurred in children, and 68.9% were associated with excessive intake. Most AEs manifested as gastrointestinal and/or neurological symptoms. Ninety-six were classified as serious; these were caused by Ginkgo semen (29 cases), Armeniacae semen amarum (60 cases), Persicae semen (4 cases), Canavaliae semen (2 cases), and Myristicae semen (1 case). These SAEs resulted in 15 fatalities and 3 cases of permanent functional impairment. Causality with seed consumption was determined to be "certain" for 239 AEs, "probable" for 449, and "possible" for 15. No AE reports were found for thirteen seeds.
Conclusion
Consuming specific medicinal and edible seeds, particularly Ginkgo semen, Armeniacae semen amarum, Persicae semen, Myristicae semen, and Canavaliae semen, poses potential risks, including fatal cases. Excessive dosages, consumption by children, and inappropriate processing were primary causes. Therefore, strengthening safety management for these is warranted.
{"title":"Safety of medicinal and edible herbs from seed sources for human consumption: A systematic review","authors":"Lixia Yuan , Bofei Shu , Jieyi Zhou , Wenxi Li , Hui Wang , Xu Zhou","doi":"10.1016/j.imr.2025.101263","DOIUrl":"10.1016/j.imr.2025.101263","url":null,"abstract":"<div><h3>Background</h3><div>Plant seeds constitute an important category of medicinal and edible herbs. However, assessments regarding their safety for human consumption remain insufficient. This systematic review comprehensively evaluates human safety for 21 medicinal and edible seeds.</div></div><div><h3>Methods</h3><div>Two independent reviewers screened the titles, abstracts, and fulltexts of the retrieved literature against the inclusion and exclusion criteria to identify eligible AE reports in both English (PubMed, Embase, CENTRAL) and Chinese (CNKI, Wanfang, VIP, SinoMed) databases. Search strategies were constructed using the scientific names, common names, and frequent aliases of the medicinal and edible seeds combined with safety evaluation keywords such as \"adverse reaction,\" \"toxicity,\" and \"side effect.\" Any studies describing adverse event (AE) after human intake of specific seeds were included. AE characteristics were summarized. Causality between seed consumption and AEs was assessed.</div></div><div><h3>Results</h3><div>We identified 703 AEs involving eight medicinal and edible seeds. Ginkgo semen and Armeniacae semen amarum caused the most AEs, followed by Persicae semen, Myristicae semen, Sterculiae lychnophorae semen, Canavaliae semen, Cassiae semen, and Ziziphi spinosae semen. Among the AEs, 70.8% occurred in children, and 68.9% were associated with excessive intake. Most AEs manifested as gastrointestinal and/or neurological symptoms. Ninety-six were classified as serious; these were caused by Ginkgo semen (29 cases), Armeniacae semen amarum (60 cases), Persicae semen (4 cases), Canavaliae semen (2 cases), and Myristicae semen (1 case). These SAEs resulted in 15 fatalities and 3 cases of permanent functional impairment. Causality with seed consumption was determined to be \"certain\" for 239 AEs, \"probable\" for 449, and \"possible\" for 15. No AE reports were found for thirteen seeds.</div></div><div><h3>Conclusion</h3><div>Consuming specific medicinal and edible seeds, particularly Ginkgo semen, Armeniacae semen amarum, Persicae semen, Myristicae semen, and Canavaliae semen, poses potential risks, including fatal cases. Excessive dosages, consumption by children, and inappropriate processing were primary causes. Therefore, strengthening safety management for these is warranted.</div></div><div><h3>Protocol registration</h3><div>PROSPERO (No. CRD42023426497).</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101263"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525682","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 : 2025-10-11DOI: 10.1016/j.imr.2025.101264
Sohee Moon , Yena Oh , Hajin Noh , Soo Dong Kim , Jae Youl Cho
Background
Polycystic ovarian syndrome (PCOS), which affects approximately 10 % of women of reproductive age worldwide, is closely associated with metabolic disturbances such as obesity and insulin resistance. Despite its high prevalence, the pathophysiology of PCOS is still not fully understood, underscoring the need for appropriate animal models and effective therapeutic strategies.
Methods
In this study, we established a PCOS mouse model through subcutaneous administration of dehydroepiandrosterone (DHEA) and investigated the therapeutic potential of a pomegranate (Punica granatum L.) hot water extract (Pg-hWE) (also called ESTROBAL®), administered orally.
Results
Histological analysis of ovarian tissue sections of mice showed that Pg-hWE improved ovulation function and suppressed cell death of follicles by promoting maintenance and regeneration of corpus luteum and reducing the number of atretic follicles. Furthermore, Pg-hWE showed inhibitory effects on gene and protein levels of apoptosis factors such as BAX, cleaved caspase-3, and cleaved caspase-9 in ovarian and uterine tissues. In addition, in ovarian tissues, it promoted apoptosis such as BAX and inhibited the expression of inflammation-related genes such as IL-6, TNF-α, and IFN-γ, while increasing the expression of Bcl-2, an anti-apoptosis factor. Plus, Pg-hWE demonstrated the ability to modulate hormonal balance by regulating the expression of CYP11A1 and CYP17A1, key genes encoding enzymes involved in androgen biosynthesis. Supporting these findings, studies using CHO-K1 cells confirmed that Pg-hWE exerts both anti-apoptotic and antioxidant effects, thereby linking its roles in mitigating PCOS, suppressing cell death, and controlling oxidative stress.
Conclusion
Collectively, these results indicate that Pg-hWE ameliorates PCOS-related pathology by reducing oxidative stress, suppressing apoptosis, and supporting hormonal balance, highlighting its promise as a natural therapeutic candidate.
{"title":"Therapeutic effects of pomegranate hot-water extract via inhibition of apoptosis and oxidative stress in a DHEA-induced mouse model of PCOS","authors":"Sohee Moon , Yena Oh , Hajin Noh , Soo Dong Kim , Jae Youl Cho","doi":"10.1016/j.imr.2025.101264","DOIUrl":"10.1016/j.imr.2025.101264","url":null,"abstract":"<div><h3>Background</h3><div>Polycystic ovarian syndrome (PCOS), which affects approximately 10 % of women of reproductive age worldwide, is closely associated with metabolic disturbances such as obesity and insulin resistance. Despite its high prevalence, the pathophysiology of PCOS is still not fully understood, underscoring the need for appropriate animal models and effective therapeutic strategies.</div></div><div><h3>Methods</h3><div>In this study, we established a PCOS mouse model through subcutaneous administration of dehydroepiandrosterone (DHEA) and investigated the therapeutic potential of a pomegranate (<em>Punica granatum</em> L.) hot water extract (Pg-hWE) (also called ESTROBAL®), administered orally.</div></div><div><h3>Results</h3><div>Histological analysis of ovarian tissue sections of mice showed that Pg-hWE improved ovulation function and suppressed cell death of follicles by promoting maintenance and regeneration of corpus luteum and reducing the number of atretic follicles. Furthermore, Pg-hWE showed inhibitory effects on gene and protein levels of apoptosis factors such as BAX, cleaved caspase-3, and cleaved caspase-9 in ovarian and uterine tissues. In addition, in ovarian tissues, it promoted apoptosis such as BAX and inhibited the expression of inflammation-related genes such as IL-6, TNF-α, and IFN-γ, while increasing the expression of Bcl-2, an anti-apoptosis factor. Plus, Pg-hWE demonstrated the ability to modulate hormonal balance by regulating the expression of CYP11A1 and CYP17A1, key genes encoding enzymes involved in androgen biosynthesis. Supporting these findings, studies using CHO-K1 cells confirmed that Pg-hWE exerts both anti-apoptotic and antioxidant effects, thereby linking its roles in mitigating PCOS, suppressing cell death, and controlling oxidative stress.</div></div><div><h3>Conclusion</h3><div>Collectively, these results indicate that Pg-hWE ameliorates PCOS-related pathology by reducing oxidative stress, suppressing apoptosis, and supporting hormonal balance, highlighting its promise as a natural therapeutic candidate.</div></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":"15 2","pages":"Article 101264"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576167","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 : 2025-10-10DOI: 10.1016/j.imr.2025.101261
Matthew J. Leach , Yasamin Veziari , Simon DuBois , Reine DuBois
Background
Evidence suggests that some models of care may have a positive impact on health worker wellbeing and retention. This study set out to understand health practitioners’ experiences of working within an integrative health care (IHC) setting in Australia, and the impact of such on practitioners’ clinical behaviour and well-being.
Methods
The study employed a qualitative descriptive design and purposive sampling. Health care practitioners of any discipline working in an IHC setting in Australia in a clinical capacity were invited to participate in an online, semi-structured interview. Interview audio-recordings were transcribed verbatim and analysed using deductive thematic analysis.
Results
Twenty-four health practitioners from twelve distinct professions partook in an interview. Four themes emerged from the data, including (i) Transition to practice (e.g. Changed approach to patient care), (ii) Professional interactions (e.g. changing perceptions of, and relationships with other healthcare providers), (iii) Job satisfaction (e.g. rewards and frustrations of working in an IHC setting), and (iv) Impacts on health and wellbeing (e.g. positive and negative health impacts).
Conclusion
The study uncovered new insights into health practitioners’ experiences of working within an IHC setting; including impacts on clinical knowledge, skills, behaviours and relationships, as well as practitioner health, wellbeing and job satisfaction. Given the potential implications of these findings on health workforce supply, quality of care and patient satisfaction, there is a need to build upon this work to determine whether the implementation of IHC models of care in different settings yields meaningful and sustainable clinical, social and economic benefit.
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Pub Date : 2025-10-06DOI: 10.1016/j.imr.2025.101259
Darshan H. Mehta , Melinda Ring
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