Pub Date : 2026-01-01DOI: 10.1016/j.joim.2025.09.005
Shan Wang , Ye-hua Xue , Li-bing Liang , Kun-peng Li , Cai-qin Wu
Background
Acupuncture is recognized as an alternative therapy for rheumatoid arthritis (RA) pain, but its efficacy evaluations are often confounded by variability in sham acupuncture techniques. The accurate selection of sham acupuncture controls, which are administered at either therapeutic acupuncture points or non-acupuncture points, is crucial for the validity of assessment outcomes.
Objective
To assess the efficacy of acupuncture in treating RA pain and identify the most effective acupuncture methods.
Search strategy
Databases including MEDLINE, Embase, PubMed, Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure Database, Chinese Science and Technology Journal Database, and Wanfang Database were searched from inception to October 11, 2024. Keywords included “rheumatoid arthritis,” “acupuncture,” “electroacupuncture,” and “pain.”
Inclusion criteria
Randomized controlled trials (RCTs) in adults with RA that assessed pain using a visual analog scale and joint swelling by swollen joint count. Eligible trials compared electroacupuncture, conventional acupuncture, or sham acupuncture, against standard pain medication.
Data extraction and analysis
Two reviewers independently extracted data on study design, participant characteristics, interventions and outcomes. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and evidence certainty was assessed via the confidence in network meta-analysis framework. A frequentist network meta-analysis with random-effect models was conducted, and standardized mean difference (SMD) and 95% confidence interval (CI) were reported.
Results
Ten RCTs involving 704 participants were analyzed. Electroacupuncture (SMD: –1.42; 95% CI: [–1.87, –0.98]) and conventional acupuncture (SMD: –1.11; 95% CI: [–1.49, –0.73]) outperformed conventional therapy and non-acupoint sham needling. Surface under cumulative ranking curve showed that electroacupuncture was most effective for pain reduction (97.7%), followed by conventional acupuncture (75.1%), non-acupoint sham (29.1%), same-acupoint sham (28.6%), and conventional therapy (19.5%).
Conclusion
Electroacupuncture demonstrated the highest efficacy for RA pain relief. Same-acupoint sham acupuncture may underestimate acupuncture’s true effect and is not recommended as a placebo control. Non-acupoint sham acupuncture is a more valid control for future trials.
Please cite this article as: Wang S, Xue YH, Liang LB, Li KP, Wu CQ. Comparative effectiveness of electroacupuncture and conventional acupuncture for rheumatoid arthritis pain: A network meta-analysis with emphasis on placebo control validity. J Integr Med. 2026; 24(1):57–64.
背景:针灸被认为是治疗类风湿关节炎(RA)疼痛的一种替代疗法,但其疗效评估常常因假针灸技术的可变性而混淆。在治疗性穴位或非针灸穴位进行假针灸对照的准确选择对于评估结果的有效性至关重要。目的:评价针刺治疗类风湿性关节炎疼痛的疗效,确定最有效的针刺方法。检索策略:从项目成立至2024年10月11日检索MEDLINE、Embase、PubMed、Cochrane Library、Scopus、Web of Science、中国国家知识基础数据库、中国科技期刊库、万方数据库等数据库。关键词包括“类风湿关节炎”、“针灸”、“电针”和“疼痛”。纳入标准:随机对照试验(rct)在成人RA患者中使用视觉模拟量表评估疼痛,通过肿胀关节计数评估关节肿胀。符合条件的试验比较了电针、传统针灸或假针灸与标准止痛药的疗效。数据提取和分析:两位评论者独立提取研究设计、参与者特征、干预措施和结果的数据。使用Cochrane Risk of bias 2工具评估偏倚风险,并通过网络元分析框架的置信度评估证据确定性。采用随机效应模型进行频率网络元分析,并报告标准化平均差(SMD)和95%置信区间(CI)。结果:共分析10项随机对照试验,共704名受试者。电针(SMD: -1.42; 95% CI:[-1.87, -0.98])和常规针刺(SMD: -1.11; 95% CI:[-1.49, -0.73])优于常规疗法和非穴位假针刺。累积排序曲线表显示,电针镇痛效果最佳(97.7%),其次为常规针刺(75.1%)、非穴位假手术(29.1%)、同穴位假手术(28.6%)、常规治疗(19.5%)。结论:电针对RA疼痛的缓解效果最好。同一穴位的假针灸可能低估了针灸的真实效果,不推荐作为安慰剂对照。在未来的试验中,非穴位假针灸是一种更有效的对照。本文署名:王思、薛玉华、梁宝玲、李kp、吴春青。电针与传统针刺治疗类风湿关节炎疼痛的比较疗效:一项强调安慰剂对照效度的网络meta分析。集成医学[J];打印前Epub。
{"title":"Comparative effectiveness of electroacupuncture and conventional acupuncture for rheumatoid arthritis pain: A network meta-analysis with emphasis on placebo control validity","authors":"Shan Wang , Ye-hua Xue , Li-bing Liang , Kun-peng Li , Cai-qin Wu","doi":"10.1016/j.joim.2025.09.005","DOIUrl":"10.1016/j.joim.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Acupuncture is recognized as an alternative therapy for rheumatoid arthritis (RA) pain, but its efficacy evaluations are often confounded by variability in sham acupuncture techniques. The accurate selection of sham acupuncture controls, which are administered at either therapeutic acupuncture points or non-acupuncture points, is crucial for the validity of assessment outcomes.</div></div><div><h3>Objective</h3><div>To assess the efficacy of acupuncture in treating RA pain and identify the most effective acupuncture methods.</div></div><div><h3>Search strategy</h3><div>Databases including MEDLINE, Embase, PubMed, Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure Database, Chinese Science and Technology Journal Database, and Wanfang Database were searched from inception to October 11, 2024. Keywords included “rheumatoid arthritis,” “acupuncture,” “electroacupuncture,” and “pain.”</div></div><div><h3>Inclusion criteria</h3><div>Randomized controlled trials (RCTs) in adults with RA that assessed pain using a visual analog scale and joint swelling by swollen joint count. Eligible trials compared electroacupuncture, conventional acupuncture, or sham acupuncture, against standard pain medication.</div></div><div><h3>Data extraction and analysis</h3><div>Two reviewers independently extracted data on study design, participant characteristics, interventions and outcomes. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and evidence certainty was assessed via the confidence in network meta-analysis framework. A frequentist network meta-analysis with random-effect models was conducted, and standardized mean difference (SMD) and 95% confidence interval (CI) were reported.</div></div><div><h3>Results</h3><div>Ten RCTs involving 704 participants were analyzed. Electroacupuncture (SMD: –1.42; 95% CI: [–1.87, –0.98]) and conventional acupuncture (SMD: –1.11; 95% CI: [–1.49, –0.73]) outperformed conventional therapy and non-acupoint sham needling. Surface under cumulative ranking curve showed that electroacupuncture was most effective for pain reduction (97.7%), followed by conventional acupuncture (75.1%), non-acupoint sham (29.1%), same-acupoint sham (28.6%), and conventional therapy (19.5%).</div></div><div><h3>Conclusion</h3><div>Electroacupuncture demonstrated the highest efficacy for RA pain relief. Same-acupoint sham acupuncture may underestimate acupuncture’s true effect and is not recommended as a placebo control. Non-acupoint sham acupuncture is a more valid control for future trials.</div><div><br>Please cite this article as: Wang S, Xue YH, Liang LB, Li KP, Wu CQ. Comparative effectiveness of electroacupuncture and conventional acupuncture for rheumatoid arthritis pain: A network meta-analysis with emphasis on placebo control validity. <em>J Integr Med</em>. 2026; 24(1):57–64.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 1","pages":"Pages 57-64"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.joim.2025.09.004
Yu-pei Cheng , Yang Guo , Can Wang , Bang-qi Wu , Qing Xia , Run-chen Zhang , Yi Guo
This study summarizes and discusses the characteristics and essence of meridians and acupoints from the perspectives of physics, chemistry and biology. An extensive body of literature from PubMed and the China National Knowledge Infrastructure was reviewed and categorized into three distinct groups: physical characteristics-related research (75 articles), which examined electrical, thermal, optical, acoustic and magnetic properties, and isotope migration; chemical characteristics-related literature (44 articles), focusing on chemical ions, oxygen partial pressure, nitric oxide and substance P; and biological essence-related research (52 articles), which primarily explored microcirculation, extracellular fluid channels, mast cells, telocytes, connexins, hilum of muscle and bone, and sensory nerve fibers. Current research emphasizes the electrical and thermal properties of the meridians and acupoints, whereas investigations into the essence of meridians are increasingly shifting from macroscopic to microscopic structures. It is essential to fully harness the advantages of interdisciplinary integration, which could significantly advance our understanding and applications in the realm of acupuncture and traditional medicine.
Please cite this article as: Cheng YP, Guo Y, Wang C, Wu BQ, Xia Q, Zhang RC, Guo Y. Research progress on the characteristics and essence of meridians and acupoints from an interdisciplinary perspective: A review. J Integr Med. 2026; 24(1):33–49.
{"title":"Research progress on the characteristics and essence of meridians and acupoints from an interdisciplinary perspective: A review","authors":"Yu-pei Cheng , Yang Guo , Can Wang , Bang-qi Wu , Qing Xia , Run-chen Zhang , Yi Guo","doi":"10.1016/j.joim.2025.09.004","DOIUrl":"10.1016/j.joim.2025.09.004","url":null,"abstract":"<div><div>This study summarizes and discusses the characteristics and essence of meridians and acupoints from the perspectives of physics, chemistry and biology. An extensive body of literature from PubMed and the China National Knowledge Infrastructure was reviewed and categorized into three distinct groups: physical characteristics-related research (75 articles), which examined electrical, thermal, optical, acoustic and magnetic properties, and isotope migration; chemical characteristics-related literature (44 articles), focusing on chemical ions, oxygen partial pressure, nitric oxide and substance P; and biological essence-related research (52 articles), which primarily explored microcirculation, extracellular fluid channels, mast cells, telocytes, connexins, hilum of muscle and bone, and sensory nerve fibers. Current research emphasizes the electrical and thermal properties of the meridians and acupoints, whereas investigations into the essence of meridians are increasingly shifting from macroscopic to microscopic structures. It is essential to fully harness the advantages of interdisciplinary integration, which could significantly advance our understanding and applications in the realm of acupuncture and traditional medicine.</div><div><br>Please cite this article as: Cheng YP, Guo Y, Wang C, Wu BQ, Xia Q, Zhang RC, Guo Y. Research progress on the characteristics and essence of meridians and acupoints from an interdisciplinary perspective: A review. <em>J Integr Med</em>. 2026; 24(1):33–49.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 1","pages":"Pages 33-48"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.joim.2025.11.001
Wen-hao Gao , Yu Wang , Xiao-yu Tong, Wei Hu, Yi-cong Wang, Yan Xiao, Jia-jia Li, Yi Feng
Acupuncture therapy has demonstrated therapeutic effects on various systemic diseases through the use of specific acupoints along meridians. However, due to the multi-target effect of acupuncture and the complexity of meridian pathways, the underlying mechanisms of acupuncture have not been well understood. Tissue clearing and three-dimensional (3D) imaging is an emerging medical technology that provides high-resolution 3D molecular information while preserving the structural integrity of tissues. In relevant research articles, tissue-clearing and 3D imaging techniques stood out for their ability to visualize the structural characteristics of meridians and acupoints of intact tissues, in order to reveal their intricate connections by means of topological principles. Specifically, this technology has managed to show that acupuncture points like Guilai (ST29) and Sanyinjiao (SP6), which are commonly used in traditional Chinese medicine for treating gynecological disorders, promote angiogenesis in the ovaries and thus improve follicle numbers in polycystic ovary syndrome-like ovaries. This article summarizes recent progress on tissue-clearing and 3D imaging technologies and anticipates the prospects of utilizing this technology to further explore the effects of acupuncture.
Please cite this article as: Gao WH, Wang Y, Tong XY, Hu W, Wang YC, Xiao Y, Li JJ, Feng Y. Research progress of tissue clearing and three-dimensional imaging on multiple effects of acupuncture and moxibustion. J Integr Med. 2026; 24(1):49–56.
{"title":"Research progress of tissue clearing and three-dimensional imaging on multiple effects of acupuncture and moxibustion","authors":"Wen-hao Gao , Yu Wang , Xiao-yu Tong, Wei Hu, Yi-cong Wang, Yan Xiao, Jia-jia Li, Yi Feng","doi":"10.1016/j.joim.2025.11.001","DOIUrl":"10.1016/j.joim.2025.11.001","url":null,"abstract":"<div><div>Acupuncture therapy has demonstrated therapeutic effects on various systemic diseases through the use of specific acupoints along meridians. However, due to the multi-target effect of acupuncture and the complexity of meridian pathways, the underlying mechanisms of acupuncture have not been well understood. Tissue clearing and three-dimensional (3D) imaging is an emerging medical technology that provides high-resolution 3D molecular information while preserving the structural integrity of tissues. In relevant research articles, tissue-clearing and 3D imaging techniques stood out for their ability to visualize the structural characteristics of meridians and acupoints of intact tissues, in order to reveal their intricate connections by means of topological principles. Specifically, this technology has managed to show that acupuncture points like Guilai (ST29) and Sanyinjiao (SP6), which are commonly used in traditional Chinese medicine for treating gynecological disorders, promote angiogenesis in the ovaries and thus improve follicle numbers in polycystic ovary syndrome-like ovaries. This article summarizes recent progress on tissue-clearing and 3D imaging technologies and anticipates the prospects of utilizing this technology to further explore the effects of acupuncture.</div><div><br>Please cite this article as: Gao WH, Wang Y, Tong XY, Hu W, Wang YC, Xiao Y, Li JJ, Feng Y. Research progress of tissue clearing and three-dimensional imaging on multiple effects of acupuncture and moxibustion. <em>J Integr Med</em>. 2026; 24(1):49–56.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 1","pages":"Pages 49-56"},"PeriodicalIF":4.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.joim.2025.12.011
Mei Han, Xue-Fang Liang, Jing Gao, Yan Wang, Li-Xing Cao, Bao-Jin Wang, Yue Wang, Zerang Zhuoma, Jian-Ping Liu, Hui-Lan Du
<p><strong>Background: </strong>Endometriosis is an estrogen-dependent, progesterone-resistant gynecological disorder, with dysmenorrhea being the most common manifestation.</p><p><strong>Objective: </strong>This study evaluates the efficacy and safety of the Tibetan herbal medication Honghua Ruyi Pill (HHRY) in managing endometriosis-related dysmenorrhea.</p><p><strong>Design, setting, participants and interventions: </strong>This is a multi-center, randomized, placebo-controlled, double-blinded clinical trial conducted in seven hospitals in China from July 2021 to January 2023. A total of 164 patients with endometriosis and moderate or severe dysmenorrhea (visual analog scale [VAS] score ≥ 4) were assigned to the treatment or placebo group in a 1:1 ratio by block randomization. Patients received HHRY or placebo twice a day for three consecutive menstrual cycles (MCs) and were followed up for three MCs after stopping the medication.</p><p><strong>Main outcome measures: </strong>Primary outcomes were VAS score of the maximum (VAS<sub>max</sub>) of dysmenorrhea, endometriosis health profile-5 (EHP-5) score, and 5-level EQ-5D version (EQ-5D-5L) score. Secondary outcomes were VAS<sub>max</sub> of non-menstrual pelvic pain, days of leave taken, emergent use of nonsteroidal anti-inflammatory drugs (NSAIDs) and changes in uterine, cyst and nodule sizes. Safety profiles were assessed based on adverse events, vital signs, serology markers, urinalysis, and liver and kidney function indicators.</p><p><strong>Results: </strong>VAS<sub>max</sub> of dysmenorrhea, EHP-5 score, EQ-5D-5 L score, and VAS<sub>max</sub> of non-menstrual pelvic pain were significantly lower in the HHRY group compared to the placebo group at the final follow-up (3.00 vs 5.50, P < 0.001; 4.00 vs 8.00, P < 0.001; 4.00 vs 9.00, P < 0.001; 0.00 vs 1.00, P < 0.001; respectively). The emergent use of NSAIDs for breakthrough pain showed no significant difference between groups (P > 0.999), but the number of patients who had taken time off was significantly different (5.00 vs 14.00, P = 0.028). Sonographic evaluations indicated no significant change in uterine size (P = 0.183) but showed a significant reduction in cyst size (2.09 cm vs 0.20 cm, P = 0.027, sum of 3 diameters of cysts) and nodule size (0.70 cm vs 0.00 cm, P < 0.001, maximum nodule diameter). Safety analysis showed no significant difference in the incidence of adverse events between groups (18.85% vs 28.05%, P = 0.059).</p><p><strong>Conclusion: </strong>HHRY can improve dysmenorrhea, chronic pelvic pain, and quality of life in patients with endometriosis. It has a good overall safety profile, and a 3-month treatment can maintain its effects for at least 3 months after the last dose. HHRY may be considered as a new therapeutic option for treating endometriosis-related dysmenorrhea.</p><p><strong>Trial registration: </strong>Trial registration at ClinicalTrials.gov with registration number: NCT04942015. Please cite this article
背景:子宫内膜异位症是一种雌激素依赖、黄体酮抵抗的妇科疾病,以痛经为最常见的表现。目的:评价藏药红花如意丸治疗子宫内膜异位症相关性痛经的疗效和安全性。设计、环境、参与者和干预措施:这是一项多中心、随机、安慰剂对照、双盲临床试验,于2021年7月至2023年1月在中国7家医院进行。164例子宫内膜异位症合并中度或重度痛经患者(视觉模拟评分[VAS]评分≥4)按照1:1的比例被分组分为治疗组或安慰剂组。患者接受HHRY或安慰剂治疗,每天两次,连续三个月经周期(MCs),停药后随访三个MCs。主要结局指标:主要结局为痛经最大VAS评分(VASmax)、子宫内膜异位症健康概况-5 (EHP-5)评分、5级EQ-5D版本评分(EQ-5D- 5l)。次要指标为非经期盆腔疼痛的VASmax、休假天数、非甾体抗炎药(NSAIDs)的紧急使用以及子宫、囊肿和结节大小的变化。安全性评估基于不良事件、生命体征、血清学指标、尿液分析和肝肾功能指标。结果:末次随访时,hhrry组痛经VASmax评分、EHP-5评分、eq - 5d - 5l评分、非经期盆腔疼痛VASmax评分均显著低于安慰剂组(3.00 vs 5.50, P 0.999),但休假患者数差异有统计学意义(5.00 vs 14.00, P = 0.028)。超声检查显示子宫大小无明显变化(P = 0.183),但囊肿大小(2.09 cm vs 0.20 cm, P = 0.027, 3个囊肿直径的总和)和结节大小(0.70 cm vs 0.00 cm, P)明显减少。结论:HHRY可改善子宫内膜异位症患者的痛经、慢性盆腔疼痛和生活质量。它具有良好的整体安全性,并且3个月的治疗可以在最后一次剂量后至少3个月保持其效果。HHRY可能被认为是治疗子宫内膜异位症相关痛经的一种新的治疗选择。试验注册:在ClinicalTrials.gov上注册试验,注册号:NCT04942015。本文署名:韩敏,梁晓峰,高军,王毅,曹立新,王炳杰,王毅,泽忠,刘金平,杜海龙。复方中药红花如意丸改善子宫内膜异位症相关性痛经:多中心随机、双盲、安慰剂对照试验集成医学[J];打印前Epub。
{"title":"Honghua Ruyi Pill, a compound herbal medicine, improves endometriosis-related dysmenorrhea: A multicenter randomized, double-blind, placebo-controlled trial.","authors":"Mei Han, Xue-Fang Liang, Jing Gao, Yan Wang, Li-Xing Cao, Bao-Jin Wang, Yue Wang, Zerang Zhuoma, Jian-Ping Liu, Hui-Lan Du","doi":"10.1016/j.joim.2025.12.011","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.011","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is an estrogen-dependent, progesterone-resistant gynecological disorder, with dysmenorrhea being the most common manifestation.</p><p><strong>Objective: </strong>This study evaluates the efficacy and safety of the Tibetan herbal medication Honghua Ruyi Pill (HHRY) in managing endometriosis-related dysmenorrhea.</p><p><strong>Design, setting, participants and interventions: </strong>This is a multi-center, randomized, placebo-controlled, double-blinded clinical trial conducted in seven hospitals in China from July 2021 to January 2023. A total of 164 patients with endometriosis and moderate or severe dysmenorrhea (visual analog scale [VAS] score ≥ 4) were assigned to the treatment or placebo group in a 1:1 ratio by block randomization. Patients received HHRY or placebo twice a day for three consecutive menstrual cycles (MCs) and were followed up for three MCs after stopping the medication.</p><p><strong>Main outcome measures: </strong>Primary outcomes were VAS score of the maximum (VAS<sub>max</sub>) of dysmenorrhea, endometriosis health profile-5 (EHP-5) score, and 5-level EQ-5D version (EQ-5D-5L) score. Secondary outcomes were VAS<sub>max</sub> of non-menstrual pelvic pain, days of leave taken, emergent use of nonsteroidal anti-inflammatory drugs (NSAIDs) and changes in uterine, cyst and nodule sizes. Safety profiles were assessed based on adverse events, vital signs, serology markers, urinalysis, and liver and kidney function indicators.</p><p><strong>Results: </strong>VAS<sub>max</sub> of dysmenorrhea, EHP-5 score, EQ-5D-5 L score, and VAS<sub>max</sub> of non-menstrual pelvic pain were significantly lower in the HHRY group compared to the placebo group at the final follow-up (3.00 vs 5.50, P < 0.001; 4.00 vs 8.00, P < 0.001; 4.00 vs 9.00, P < 0.001; 0.00 vs 1.00, P < 0.001; respectively). The emergent use of NSAIDs for breakthrough pain showed no significant difference between groups (P > 0.999), but the number of patients who had taken time off was significantly different (5.00 vs 14.00, P = 0.028). Sonographic evaluations indicated no significant change in uterine size (P = 0.183) but showed a significant reduction in cyst size (2.09 cm vs 0.20 cm, P = 0.027, sum of 3 diameters of cysts) and nodule size (0.70 cm vs 0.00 cm, P < 0.001, maximum nodule diameter). Safety analysis showed no significant difference in the incidence of adverse events between groups (18.85% vs 28.05%, P = 0.059).</p><p><strong>Conclusion: </strong>HHRY can improve dysmenorrhea, chronic pelvic pain, and quality of life in patients with endometriosis. It has a good overall safety profile, and a 3-month treatment can maintain its effects for at least 3 months after the last dose. HHRY may be considered as a new therapeutic option for treating endometriosis-related dysmenorrhea.</p><p><strong>Trial registration: </strong>Trial registration at ClinicalTrials.gov with registration number: NCT04942015. Please cite this article ","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.joim.2025.12.008
Yi-Bo Zhang, Lin Xu, Man Yuan, Meng-Fan Liu, Yang Li, Xuan-Lei Zhong, Zhi-Xiu Lin, Yan-Fang Xian, Ping Lu, Zhi-Chao Xi, Hong-Xi Xu
Objective: Enhancing innate immunity through interferons (IFNs) and IFN-stimulated genes (ISGs) offers a promising strategy for preventing herpes simplex virus type 1 (HSV-1) infection. Prunella vulgaris L., a medicinal herb, has demonstrated significant anti-HSV activity; in particular, its derived polysaccharide complex (PVE30) effectively inhibits viral replication. In this study, we investigate whether PVE30 exerts an anti-HSV-1 activity through activation of the innate immune response.
Methods: To determine the primary stage at which PVE30 exerts its effects during the HSV-1 life cycle, plaque reduction assays were conducted. Viral infection was further assessed by investigating the DNA copies, mRNA levels and protein expression of HSV-1 in infected cells using real-time polymerase chain reaction (RT-PCR) and Western blotting. The activation of the innate immune response was evaluated by detecting mRNA levels of ISGs, including MX dynamin-like GTPase 1 (Mx1), Mx2, 2'-5'-oligoadenylate synthetase 1 (OAS1), ISG15 and IFN regulatory factor 7 (IRF7) using RT-PCR, and levels of TANK-binding kinase 1 (TBK1) and IRF3 proteins using Western blotting. The translocation of phosphorylated IRF3 and stimulator of IFN genes (STING) was observed through fluorescence microscopy.
Results: PVE30 pre-treatment exerted protective effects against HSV-1 infection in human immortalized keratinocytes by enhancing the innate immune response. This was shown by increased transcriptional levels of IFN-β and antiviral ISGs, along with a significant reduction in HSV-1 DNA copies, mRNA expression and protein levels. Mechanistically, PVE30 promoted TBK1 phosphorylation, leading to nuclear translocation of IRF3 and subsequent IFN-β transcription; these effects were diminished by TBK1 inhibitor GSK8612. Additionally, STING was identified as a key mediator in PVE30-activated TBK1 signaling, as its inhibition induced by C-176 reduced PVE30's efficacy.
Conclusion: This study elucidated the molecular mechanisms underlying the protective effects of PVE30 against HSV-1 infection. PVE30 exerted its protective role by enhancing STING-TBK1-IRF3 pathway-mediated innate immune response. Please cite this article as: Zhang YB, Xu L, Yuan M, Liu MF, Li Y, Zhong XL, Lin ZX, Xian YF, Lu P, Xi ZC, Xu HX. Protective effects of Prunella vulgaris polysaccharides against herpes simplex virus type 1 infection through the STING-TBK1-IRF3 pathway. J Integr Med. 2025; Epub ahead of print.
{"title":"Protective effects of Prunella vulgaris polysaccharides against herpes simplex virus type 1 infection through the STING-TBK1-IRF3 pathway.","authors":"Yi-Bo Zhang, Lin Xu, Man Yuan, Meng-Fan Liu, Yang Li, Xuan-Lei Zhong, Zhi-Xiu Lin, Yan-Fang Xian, Ping Lu, Zhi-Chao Xi, Hong-Xi Xu","doi":"10.1016/j.joim.2025.12.008","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.008","url":null,"abstract":"<p><strong>Objective: </strong>Enhancing innate immunity through interferons (IFNs) and IFN-stimulated genes (ISGs) offers a promising strategy for preventing herpes simplex virus type 1 (HSV-1) infection. Prunella vulgaris L., a medicinal herb, has demonstrated significant anti-HSV activity; in particular, its derived polysaccharide complex (PVE30) effectively inhibits viral replication. In this study, we investigate whether PVE30 exerts an anti-HSV-1 activity through activation of the innate immune response.</p><p><strong>Methods: </strong>To determine the primary stage at which PVE30 exerts its effects during the HSV-1 life cycle, plaque reduction assays were conducted. Viral infection was further assessed by investigating the DNA copies, mRNA levels and protein expression of HSV-1 in infected cells using real-time polymerase chain reaction (RT-PCR) and Western blotting. The activation of the innate immune response was evaluated by detecting mRNA levels of ISGs, including MX dynamin-like GTPase 1 (Mx1), Mx2, 2'-5'-oligoadenylate synthetase 1 (OAS1), ISG15 and IFN regulatory factor 7 (IRF7) using RT-PCR, and levels of TANK-binding kinase 1 (TBK1) and IRF3 proteins using Western blotting. The translocation of phosphorylated IRF3 and stimulator of IFN genes (STING) was observed through fluorescence microscopy.</p><p><strong>Results: </strong>PVE30 pre-treatment exerted protective effects against HSV-1 infection in human immortalized keratinocytes by enhancing the innate immune response. This was shown by increased transcriptional levels of IFN-β and antiviral ISGs, along with a significant reduction in HSV-1 DNA copies, mRNA expression and protein levels. Mechanistically, PVE30 promoted TBK1 phosphorylation, leading to nuclear translocation of IRF3 and subsequent IFN-β transcription; these effects were diminished by TBK1 inhibitor GSK8612. Additionally, STING was identified as a key mediator in PVE30-activated TBK1 signaling, as its inhibition induced by C-176 reduced PVE30's efficacy.</p><p><strong>Conclusion: </strong>This study elucidated the molecular mechanisms underlying the protective effects of PVE30 against HSV-1 infection. PVE30 exerted its protective role by enhancing STING-TBK1-IRF3 pathway-mediated innate immune response. Please cite this article as: Zhang YB, Xu L, Yuan M, Liu MF, Li Y, Zhong XL, Lin ZX, Xian YF, Lu P, Xi ZC, Xu HX. Protective effects of Prunella vulgaris polysaccharides against herpes simplex virus type 1 infection through the STING-TBK1-IRF3 pathway. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study investigated the effects of distinct electroacupuncture (EA) intensities in alleviating mechanical hypersensitivity by attenuating spinal dorsal horn (SDH) neuronal sensitization in inflammatory muscle pain.
Methods: Male Sprague-Dawley rats received an intra-muscular injection of complete Freund's adjuvant (CFA) in the left gastrocnemius muscle to induce inflammatory muscle pain. EA with distinct intensities activating Aβ-, Aδ- and C-fibers (EAAβ, EAAδ and EAC) was applied after CFA injection. Pain behaviors were evaluated by weight-bearing asymmetry, the Randall-Selitto test, and the von Frey test. Spinal neuronal activities were observed by in vivo extracellular recordings with a microelectrode array. Neuronal sensitization was assessed through wind-up phenomenon of wide dynamic range (WDR) neurons and long-term potentiation (LTP) of spinal C-fiber-evoked field potential (CFEFP).
Results: Both EAAδ and EAC significantly alleviated CFA-induced hyperalgesia. Moreover, EAAδ and EAC interventions markedly reduced the activity of WDR neurons in response to stimulation. Importantly, the wind-up phenomenon of WDR neurons evoked by repetitive noxious stimuli was both immediately and sustainably reduced after EA intervention, with EAC showing a more pronounced effect. Furthermore, EAAδ and EAC increased the threshold of the spinal CFEFP, while EAC intervention additionally significantly attenuated the occurrence of LTP.
Conclusion: Suppressing the SDH neuronal sensitization by activating Aδ- and C-fiber inputs may be the potential mechanism by which EA alleviates hyperalgesia in inflammatory muscle pain. Please cite this article as: Yu QQ, Sun XY, Chen JK, Li M, Wang XY, Su YS, Zhang ZY, Jing XH. Distinct intensity of electroacupuncture ameliorates mechanical hypersensitivity by attenuating neuronal sensitization in spinal dorsal horn in a rat model of inflammatory muscle pain. J Integr Med. 2025; Epub ahead of print.
{"title":"Distinct intensity of electroacupuncture ameliorates mechanical hypersensitivity by attenuating neuronal sensitization in spinal dorsal horn in a rat model of inflammatory muscle pain.","authors":"Qing-Quan Yu, Xiao-Yue Sun, Jun-Kang Chen, Meng Li, Xiao-Yu Wang, Yang-Shuai Su, Zhi-Yun Zhang, Xiang-Hong Jing","doi":"10.1016/j.joim.2025.12.010","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.010","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effects of distinct electroacupuncture (EA) intensities in alleviating mechanical hypersensitivity by attenuating spinal dorsal horn (SDH) neuronal sensitization in inflammatory muscle pain.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats received an intra-muscular injection of complete Freund's adjuvant (CFA) in the left gastrocnemius muscle to induce inflammatory muscle pain. EA with distinct intensities activating Aβ-, Aδ- and C-fibers (EA<sub>Aβ</sub>, EA<sub>Aδ</sub> and EA<sub>C</sub>) was applied after CFA injection. Pain behaviors were evaluated by weight-bearing asymmetry, the Randall-Selitto test, and the von Frey test. Spinal neuronal activities were observed by in vivo extracellular recordings with a microelectrode array. Neuronal sensitization was assessed through wind-up phenomenon of wide dynamic range (WDR) neurons and long-term potentiation (LTP) of spinal C-fiber-evoked field potential (CFEFP).</p><p><strong>Results: </strong>Both EA<sub>Aδ</sub> and EA<sub>C</sub> significantly alleviated CFA-induced hyperalgesia. Moreover, EA<sub>Aδ</sub> and EA<sub>C</sub> interventions markedly reduced the activity of WDR neurons in response to stimulation. Importantly, the wind-up phenomenon of WDR neurons evoked by repetitive noxious stimuli was both immediately and sustainably reduced after EA intervention, with EA<sub>C</sub> showing a more pronounced effect. Furthermore, EA<sub>Aδ</sub> and EA<sub>C</sub> increased the threshold of the spinal CFEFP, while EA<sub>C</sub> intervention additionally significantly attenuated the occurrence of LTP.</p><p><strong>Conclusion: </strong>Suppressing the SDH neuronal sensitization by activating Aδ- and C-fiber inputs may be the potential mechanism by which EA alleviates hyperalgesia in inflammatory muscle pain. Please cite this article as: Yu QQ, Sun XY, Chen JK, Li M, Wang XY, Su YS, Zhang ZY, Jing XH. Distinct intensity of electroacupuncture ameliorates mechanical hypersensitivity by attenuating neuronal sensitization in spinal dorsal horn in a rat model of inflammatory muscle pain. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-27DOI: 10.1016/j.joim.2025.12.009
Hao Chen, Xi-Fen Zhang, Zi-Chun Yuan, Xue-Song Wang, Yuan-Bo Gao, Xu-Xin Li, Jun-Cha Zhang, Michele Dias da Silva Oliveira, Cynthia Assis de Barros Nunes, Jun Liu, Yan-Fen She
Background: Auriculotherapy is a simple, convenient, nonpharmacological option that has shown positive effects for insomnia patients, but its efficacy and safety remain unknown.
Objective: The aim of this study is to evaluate the efficacy and safety of auricular therapy for insomnia.
Design, setting, participants and intervention: An 18-week (2-week screening, 4-week treatment, and 12-week follow-up), recruiter- and assessor-blinded, randomized, sham-controlled trial was performed. Patients were recruited from outpatient settings at three clinical centers in China from 2 February 2023 to 26 January 2024. Participants had insomnia for more than 3 months and met the criteria classified in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Patients were randomly assigned in a 1:1 ratio to receive auricular therapy (AT) or sham AT (SAT) for 4 consecutive weeks, twice a week, and once every 3 days.
Main outcome measures: Primary outcome was the response rate at week 4 after treatment, defined as the percentage of patients with at least a 50% reduction in Pittsburgh Sleep Quality Index (PSQI) from baseline. Secondary outcomes consisted of response rates at other time points, PSQI and 4 related scales, actigraphy-recorded sleep efficiency, sleep arousal frequency, and total sleep time.
Results: A total of 234 participants were screened, and 156 patients (122 female [78.2%]; mean [SD] age, 37.2 [13.5] years) were included in the intention-to-treat analysis, with 78 participants randomized to each group. A total of 117 participants (75%) were followed up for 3 months. The AT group had a higher response rate at week 4 than the SAT group (39.73% [29/73] vs 23.29% [17/73], P = 0.03), and the response rates for the AT and SAT groups at week 2 were 28.38% (21/74) and 13.33% (10/75), respectively (P = 0.02). The differences between the two groups in the PSQI at each time point (P < 0.05) and the Insomnia Severity Index at weeks 4 and 12 (both P = 0.03) were also statistically significant. The other partial outcomes also showed statistically significant differences. Adverse events occurred in 2 cases in the AT group (2.60%).
Conclusion: Four-week AT treatment was an effective and safe alternative therapy for insomnia, although the difference with the SAT treatment did not reach the minimal clinically important difference. Adverse events were mild or transient.
Trial registration: Chinese Clinical Trial Registry, identifier ChiCTR2200065187. Please cite this article as: Chen H, Zhang XF, Yuan ZC, Wang XS, Gao YB, Li XX, Zhang JC, da Silva Oliveira MD, de Barros Nunes CA, Liu J, She YF. Efficacy and safety of auriculotherapy for insomnia disorder: A randomized controlled trial. J Integr Med. 2025; Epub ahead of print.
背景:耳疗是一种简单、方便、非药物的治疗失眠的方法,但其疗效和安全性尚不清楚。目的:评价耳穴疗法治疗失眠症的疗效和安全性。设计、设置、参与者和干预:进行了为期18周(2周筛选、4周治疗和12周随访)的招募者和评估者盲法、随机、假对照试验。从2023年2月2日至2024年1月26日,从中国三个临床中心的门诊环境中招募患者。参与者失眠超过3个月,符合精神障碍诊断与统计手册(第五版)的分类标准。患者按1:1的比例随机分配,接受耳穴治疗(AT)或假耳穴治疗(SAT),连续4周,每周2次,每3天1次。主要结局指标:主要结局指标为治疗后第4周的缓解率,定义为匹兹堡睡眠质量指数(PSQI)较基线降低至少50%的患者百分比。次要结局包括其他时间点的反应率、PSQI和4个相关量表、活动记录仪记录的睡眠效率、睡眠唤醒频率和总睡眠时间。结果:共筛选234例受试者,156例患者(女性122例[78.2%],平均[SD]年龄37.2[13.5]岁)纳入意向治疗分析,每组随机分组78例。117例(75%)随访3个月。AT组第4周的有效率高于SAT组(39.73% [29/73]vs 23.29% [17/73], P = 0.03), AT组和SAT组第2周的有效率分别为28.38%(21/74)和13.33% (10/75),P = 0.02。结论:4周at治疗是一种有效、安全的失眠替代疗法,但与SAT治疗的差异未达到临床重要的最小差异。不良事件是轻微或短暂的。试验注册:中国临床试验注册中心,标识符ChiCTR2200065187。本文署名:陈海,张晓峰,袁志成,王学祥,高玉波,李XX,张建杰,da Silva Oliveira MD, de Barros Nunes CA,刘健,She YF。耳疗法治疗失眠的疗效和安全性:一项随机对照试验。集成医学[J];打印前Epub。
{"title":"Efficacy and safety of auriculotherapy for insomnia disorder: a randomized controlled trial.","authors":"Hao Chen, Xi-Fen Zhang, Zi-Chun Yuan, Xue-Song Wang, Yuan-Bo Gao, Xu-Xin Li, Jun-Cha Zhang, Michele Dias da Silva Oliveira, Cynthia Assis de Barros Nunes, Jun Liu, Yan-Fen She","doi":"10.1016/j.joim.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.009","url":null,"abstract":"<p><strong>Background: </strong>Auriculotherapy is a simple, convenient, nonpharmacological option that has shown positive effects for insomnia patients, but its efficacy and safety remain unknown.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the efficacy and safety of auricular therapy for insomnia.</p><p><strong>Design, setting, participants and intervention: </strong>An 18-week (2-week screening, 4-week treatment, and 12-week follow-up), recruiter- and assessor-blinded, randomized, sham-controlled trial was performed. Patients were recruited from outpatient settings at three clinical centers in China from 2 February 2023 to 26 January 2024. Participants had insomnia for more than 3 months and met the criteria classified in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Patients were randomly assigned in a 1:1 ratio to receive auricular therapy (AT) or sham AT (SAT) for 4 consecutive weeks, twice a week, and once every 3 days.</p><p><strong>Main outcome measures: </strong>Primary outcome was the response rate at week 4 after treatment, defined as the percentage of patients with at least a 50% reduction in Pittsburgh Sleep Quality Index (PSQI) from baseline. Secondary outcomes consisted of response rates at other time points, PSQI and 4 related scales, actigraphy-recorded sleep efficiency, sleep arousal frequency, and total sleep time.</p><p><strong>Results: </strong>A total of 234 participants were screened, and 156 patients (122 female [78.2%]; mean [SD] age, 37.2 [13.5] years) were included in the intention-to-treat analysis, with 78 participants randomized to each group. A total of 117 participants (75%) were followed up for 3 months. The AT group had a higher response rate at week 4 than the SAT group (39.73% [29/73] vs 23.29% [17/73], P = 0.03), and the response rates for the AT and SAT groups at week 2 were 28.38% (21/74) and 13.33% (10/75), respectively (P = 0.02). The differences between the two groups in the PSQI at each time point (P < 0.05) and the Insomnia Severity Index at weeks 4 and 12 (both P = 0.03) were also statistically significant. The other partial outcomes also showed statistically significant differences. Adverse events occurred in 2 cases in the AT group (2.60%).</p><p><strong>Conclusion: </strong>Four-week AT treatment was an effective and safe alternative therapy for insomnia, although the difference with the SAT treatment did not reach the minimal clinically important difference. Adverse events were mild or transient.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, identifier ChiCTR2200065187. Please cite this article as: Chen H, Zhang XF, Yuan ZC, Wang XS, Gao YB, Li XX, Zhang JC, da Silva Oliveira MD, de Barros Nunes CA, Liu J, She YF. Efficacy and safety of auriculotherapy for insomnia disorder: A randomized controlled trial. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Xinyang Tablet (XYAT) and Xinyin Tablet (XYIT) have been used to treat chronic heart failure (CHF) for 20 years. This study investigated their pharmacodynamic material basis and underlying mechanisms of action.
Methods: Ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UPLC-HRMS) was used to identify the components of XYAT and XYIT, and to profile their metabolites in plasma and urine samples from both rats and human volunteers. Furthermore, the prototype compounds and their pharmacokinetics were evaluated using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Network pharmacology predicted potential targets and pathways, which were subsequently validated through flow cytometry and Western blot. The efficacy of XYAT, XYIT and their active components was evaluated in oxidative stress and cardiotoxicity models.
Results: A total of 162 and 130 compounds were detected in XYAT and XYIT, respectively; among these, 148 from XYAT and 119 from XYIT were structurally identified. A validated HPLC-MS/MS method quantified 20 key exposure components, five of which showed high systemic exposure and underwent pharmacokinetic analysis. Pharmacokinetic results indicated that the systemic exposure of most compounds was higher for XYAT than for XYIT. Using network pharmacology, seven candidate active compounds were identified, along with their predicted therapeutic targets and associated signaling pathways. Flow cytometry and Western blot confirmed that XYAT, XYIT, and their bioactive components alleviate CHF by modulating calcium signaling and phosphoinositide 3-kinase/protein kinase B signaling. Pharmacodynamic assays demonstrated that XYAT provides protection against hydrogen peroxide-induced injury, while XYIT mitigates doxorubicin-induced cytotoxicity. Further validation confirmed that 20(S)-ginsenoside Rg2 and 20(R)-ginsenoside Rh1 effectively reduced the H2O2-induced oxidative stress, while 20(S)-ginsenoside Rg2 and calycosin-7-O-β-D-glucoside significantly protected against doxorubicin-induced cytotoxicity.
Conclusion: These findings provide mechanistic insights into the pharmacodynamic material basis and anti-CHF mechanisms of XYAT and XYIT. The integrated strategy established herein offers robust evidence that the superior systemic exposure of key components underpins the rationale for XYAT's formulation and warrants its continued development in modern cardiology. Please cite this article as: Lan YL, Chen SM, Dai BX, Wu CS, Wei Y, Yang L, Yan JL, Guo YQ, Wang DW, Li QG, Yang ZQ, Xian SX, Yuan TH. Bioactive components of Xinyang and Xinyin tablets for treating chronic heart failure: pharmacokinetics, network pharmacology and experimental validation. J Integr Med. 2025; Epub ahead of print.
目的:心阳片(XYAT)和心阴片(XYIT)治疗慢性心力衰竭(CHF)已有20年的临床疗效。本研究探讨了它们的药效学、物质基础和作用机制。方法:采用超高效液相色谱-高分辨率质谱法(UPLC-HRMS)鉴定XYAT和XYIT的成分,并分析其在大鼠和人类志愿者血浆和尿液中的代谢物。采用高效液相色谱-串联质谱(HPLC-MS/MS)对原型化合物及其药代动力学进行了评价。网络药理学预测了潜在的靶点和通路,随后通过流式细胞术和Western blot验证。在氧化应激和心脏毒性模型中评价XYAT、XYIT及其活性成分的作用。结果:XYAT和XYIT中分别检出162和130个化合物;其中经结构鉴定的XYAT和XYIT分别为148和119个。经验证的HPLC-MS/MS方法对20个关键暴露成分进行了定量分析,其中5个暴露成分表现出高系统性暴露,并进行了药代动力学分析。药代动力学结果表明,大多数化合物对XYAT的全身暴露高于XYIT。利用网络药理学,确定了7种候选活性化合物,以及它们预测的治疗靶点和相关的信号通路。流式细胞术和Western blot证实,XYAT、XYIT及其生物活性成分通过调节钙信号和磷酸肌苷3-激酶/蛋白激酶B信号来缓解CHF。药效学分析表明,XYAT提供保护,防止过氧化氢诱导的损伤,而XYIT减轻阿霉素诱导的细胞毒性。进一步验证证实,20(S)-人参皂苷Rg2和20(R)-人参皂苷Rh1可有效降低h2o2诱导的氧化应激,而20(S)-人参皂苷Rg2和毛蕊异黄酮-7- o -β- d -葡萄糖苷可显著保护阿霉素诱导的细胞毒性。结论:这些发现为XYAT和XYIT的药效学、物质基础和抗chf作用机制提供了新的认识。本文建立的综合策略提供了强有力的证据,证明关键成分的优越系统性暴露支撑了XYAT配方的基本原理,并保证了其在现代心脏病学中的持续发展。本文署名:兰玉玲,陈思敏,戴宝祥,吴春春,魏勇,杨玲,颜建林,郭玉青,王大伟,李庆国,杨志强,冼世祥,袁太。心阳、心阴片治疗慢性心力衰竭的生物活性成分:药代动力学、网络药理学及实验验证。集成医学[J];打印前Epub。
{"title":"Bioactive components of Xinyang and Xinyin tablets for treating chronic heart failure: Pharmacokinetics, network pharmacology and experimental validation.","authors":"Yan-Ling Lan, Si-Mian Chen, Bin-Xin Dai, Cai-Sheng Wu, Yi Wei, Lu Yang, Jun-Lue Yan, Ya-Qiong Guo, Da-Wei Wang, Qing-Guo Li, Zhong-Qi Yang, Shao-Xiang Xian, Tian-Hui Yuan","doi":"10.1016/j.joim.2025.12.005","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.005","url":null,"abstract":"<p><strong>Objective: </strong>Xinyang Tablet (XYAT) and Xinyin Tablet (XYIT) have been used to treat chronic heart failure (CHF) for 20 years. This study investigated their pharmacodynamic material basis and underlying mechanisms of action.</p><p><strong>Methods: </strong>Ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UPLC-HRMS) was used to identify the components of XYAT and XYIT, and to profile their metabolites in plasma and urine samples from both rats and human volunteers. Furthermore, the prototype compounds and their pharmacokinetics were evaluated using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Network pharmacology predicted potential targets and pathways, which were subsequently validated through flow cytometry and Western blot. The efficacy of XYAT, XYIT and their active components was evaluated in oxidative stress and cardiotoxicity models.</p><p><strong>Results: </strong>A total of 162 and 130 compounds were detected in XYAT and XYIT, respectively; among these, 148 from XYAT and 119 from XYIT were structurally identified. A validated HPLC-MS/MS method quantified 20 key exposure components, five of which showed high systemic exposure and underwent pharmacokinetic analysis. Pharmacokinetic results indicated that the systemic exposure of most compounds was higher for XYAT than for XYIT. Using network pharmacology, seven candidate active compounds were identified, along with their predicted therapeutic targets and associated signaling pathways. Flow cytometry and Western blot confirmed that XYAT, XYIT, and their bioactive components alleviate CHF by modulating calcium signaling and phosphoinositide 3-kinase/protein kinase B signaling. Pharmacodynamic assays demonstrated that XYAT provides protection against hydrogen peroxide-induced injury, while XYIT mitigates doxorubicin-induced cytotoxicity. Further validation confirmed that 20(S)-ginsenoside Rg2 and 20(R)-ginsenoside Rh1 effectively reduced the H<sub>2</sub>O<sub>2</sub>-induced oxidative stress, while 20(S)-ginsenoside Rg2 and calycosin-7-O-β-D-glucoside significantly protected against doxorubicin-induced cytotoxicity.</p><p><strong>Conclusion: </strong>These findings provide mechanistic insights into the pharmacodynamic material basis and anti-CHF mechanisms of XYAT and XYIT. The integrated strategy established herein offers robust evidence that the superior systemic exposure of key components underpins the rationale for XYAT's formulation and warrants its continued development in modern cardiology. Please cite this article as: Lan YL, Chen SM, Dai BX, Wu CS, Wei Y, Yang L, Yan JL, Guo YQ, Wang DW, Li QG, Yang ZQ, Xian SX, Yuan TH. Bioactive components of Xinyang and Xinyin tablets for treating chronic heart failure: pharmacokinetics, network pharmacology and experimental validation. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Alzheimer's disease (AD) and Parkinson's disease (PD) are major age-related neurodegenerative disorders that currently lack effective disease-modifying therapies. This study investigated the neuroprotective potential and underlying mechanisms of natural products derived from medicine-food homology (MFH) plants, with a focus on autophagy modulation in AD and PD models.
Methods: Twenty MFH plant extracts were screened using the Caenorhabditis elegans amyloid-β peptide (Aβ) proteotoxicity model CL4176. Mung bean coat extract (MBCE) was identified as a promising candidate and subsequently evaluated in transgenic C. elegans models of AD and PD to assess its effects on pathological protein aggregation, oxidative stress, and behavioral impairments. Autophagy activation was assessed using fluorescence microscopy and lysosomal activity assays. MBCE's effects on protein aggregation and apoptosis were further validated in rat pheochromocytoma (PC-12) cells. Mechanistic insights were obtained through pharmacological inhibition of autophagy and AMP-activated protein kinase (AMPK) signaling, as well as AMPK knockdown. A bioactivity-guided analysis was performed to identify the major active constituents of MBCE.
Results: MBCE significantly alleviated Aβ- and microtubule-associated protein tau (Tau)-induced neurotoxicity in C. elegans by reducing protein aggregation, oxidative stress, and locomotor deficits. It also suppressed α-synuclein accumulation and preserved dopaminergic neuron integrity in PD models. MBCE enhanced stress resistance and activated autophagy, as evidenced by increased autophagosome formation, decreased sequestosome-1 (p62/SQSTM1) levels, and elevated lysosomal activity. RNA interference knockdown assays confirmed that MBCE's neuroprotective effects were dependent on autophagy activation. In PC-12 cells, MBCE similarly induced AMPK-mediated autophagy, reduced the accumulation of disease-related proteins, and mitigated cytotoxicity. Notably, genetic knockdown or pharmacological inhibition of AMPK or autophagy abolished these effects. Vitexin and isovitexin, the main constituents of MBCE, were identified as key contributors to its autophagy-inducing and neuroprotective activities.
Conclusion: MBCE mitigates neurodegenerative pathology in AD and PD models by promoting AMPK-dependent autophagy and reducing toxic protein aggregation. These findings support the potential of MBCE as a functional food-based therapeutic strategy for neurodegenerative diseases. Please cite this article as: Chen ZX, Wang FP, Li YP, Wu MT, Chen MY, Huang FH, Wen YP, Wang XH, Yu L, Wu JM, Wu AG, Zhou XG. Neuroprotective activity of mung bean (Vigna radiata) coat extract via AMPK-dependent autophagy in Alzheimer's and Parkinson's models. J Integr Med. 2025; Epub ahead of print.
{"title":"Neuroprotective activity of mung bean (Vigna radiata) coat extract via AMPK-dependent autophagy in Alzheimer's and Parkinson's models.","authors":"Zhi-Xiong Chen, Fang-Ping Wang, Ya-Ping Li, Meng-Ting Wu, Meng-Yi Chen, Fei-Hong Huang, Yong-Ping Wen, Xin-Hui Wang, Lu Yu, Jian-Ming Wu, An-Guo Wu, Xiao-Gang Zhou","doi":"10.1016/j.joim.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.003","url":null,"abstract":"<p><strong>Objective: </strong>Alzheimer's disease (AD) and Parkinson's disease (PD) are major age-related neurodegenerative disorders that currently lack effective disease-modifying therapies. This study investigated the neuroprotective potential and underlying mechanisms of natural products derived from medicine-food homology (MFH) plants, with a focus on autophagy modulation in AD and PD models.</p><p><strong>Methods: </strong>Twenty MFH plant extracts were screened using the Caenorhabditis elegans amyloid-β peptide (Aβ) proteotoxicity model CL4176. Mung bean coat extract (MBCE) was identified as a promising candidate and subsequently evaluated in transgenic C. elegans models of AD and PD to assess its effects on pathological protein aggregation, oxidative stress, and behavioral impairments. Autophagy activation was assessed using fluorescence microscopy and lysosomal activity assays. MBCE's effects on protein aggregation and apoptosis were further validated in rat pheochromocytoma (PC-12) cells. Mechanistic insights were obtained through pharmacological inhibition of autophagy and AMP-activated protein kinase (AMPK) signaling, as well as AMPK knockdown. A bioactivity-guided analysis was performed to identify the major active constituents of MBCE.</p><p><strong>Results: </strong>MBCE significantly alleviated Aβ- and microtubule-associated protein tau (Tau)-induced neurotoxicity in C. elegans by reducing protein aggregation, oxidative stress, and locomotor deficits. It also suppressed α-synuclein accumulation and preserved dopaminergic neuron integrity in PD models. MBCE enhanced stress resistance and activated autophagy, as evidenced by increased autophagosome formation, decreased sequestosome-1 (p62/SQSTM1) levels, and elevated lysosomal activity. RNA interference knockdown assays confirmed that MBCE's neuroprotective effects were dependent on autophagy activation. In PC-12 cells, MBCE similarly induced AMPK-mediated autophagy, reduced the accumulation of disease-related proteins, and mitigated cytotoxicity. Notably, genetic knockdown or pharmacological inhibition of AMPK or autophagy abolished these effects. Vitexin and isovitexin, the main constituents of MBCE, were identified as key contributors to its autophagy-inducing and neuroprotective activities.</p><p><strong>Conclusion: </strong>MBCE mitigates neurodegenerative pathology in AD and PD models by promoting AMPK-dependent autophagy and reducing toxic protein aggregation. These findings support the potential of MBCE as a functional food-based therapeutic strategy for neurodegenerative diseases. Please cite this article as: Chen ZX, Wang FP, Li YP, Wu MT, Chen MY, Huang FH, Wen YP, Wang XH, Yu L, Wu JM, Wu AG, Zhou XG. Neuroprotective activity of mung bean (Vigna radiata) coat extract via AMPK-dependent autophagy in Alzheimer's and Parkinson's models. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-13DOI: 10.1016/j.joim.2025.12.002
Kessy Gabrielly Pegoraro Correa, Marcella do Carmo Barroso de Siqueira, Mariana Zanovello, Manuela Martins Belmudes, Priscila de Souza, Arquimedes Gasparotto Junior, Thaise Boeing
Objective: Gastric ulcers are a global health issue, often occurring in the stomach or duodenum and causing tissue necrosis. Talinum paniculatum (Jacq.) Gaertn (Erva-gorda) is used in traditional medicine for treating gastric ulcers. This study aimed to assess the gastroprotective effects of the ethanol-soluble fraction from T. paniculatum leaves (ESTP) in rodents.
Methods: The gastroprotective potential of ESTP was evaluated at 30, 100, and 300 mg/kg taken orally, or 30 mg/kg intraperitoneally against gastric lesions induced by a 60% ethanol solution containing 0.3 mol/L hydrochloric acid, in mice. Histological sections were examined after hematoxylin-eosin staining and their mucin content was determined using the periodic acid-Schiff method. Oxidative stress markers, including levels of reduced glutathione and lipid hydroperoxide, as well as inflammatory parameters such as myeloperoxidase activity and nitrite levels, were analyzed. Mechanistic studies involved pretreating the mice with N-ethylmaleimide (NEM), N-nitro-l-arginine methyl ester (L-NAME), and indomethacin.
Results: ESTP at 300 mg/kg orally and 30 mg/kg intraperitoneally significantly reduced ethanol/HCl-induced gastric injury. It decreased lipid hydroperoxide levels but did not increase levels of reduced glutathione. Myeloperoxidase activity and nitrite levels were reduced. However, ESTP did not restore mucin levels. Pretreatment with indomethacin nullified the protective effects of ESTP while NEM and L-NAME did not.
Conclusion: ESTP demonstrated a remarkable gastroprotective effect, as indicated by reductions in inflammatory and oxidative mediators. The observed decline in mucin activity, coupled with the absence of an effect following indomethacin pretreatment, implies a potential inhibition of the cyclooxygenase activity by the extract. These findings collectively support the traditional use of the species for gastrointestinal protection and highlight its potential as a therapeutic agent for managing gastric ulcers. Please cite this article as: Pegoraro Correa KG, do Carmo Barroso de Siqueira M, Zanovello M, Martins Belmudes M, de Souza P, Gasparotto Junior A, Boeing T. Gastroprotective activity of Talinum paniculatum (Jacq.) Gaertn. in mice: An ethnopharmacological validation. J Integr Med. 2025; Epub ahead of print.
目的:胃溃疡是一个全球性的健康问题,常发生在胃或十二指肠并引起组织坏死。圆锥TalinumGaertn (Erva-gorda)在传统医学中用于治疗胃溃疡。本研究旨在探讨荆芥叶乙醇溶性部位(ESTP)对啮齿动物胃的保护作用。方法:分别以30、100、300 mg/kg口服和30 mg/kg腹腔注射ESTP对含有0.3 mol/L盐酸的60%乙醇溶液致小鼠胃损伤的保护作用。组织切片苏木精-伊红染色,周期性酸-席夫法测定粘蛋白含量。氧化应激标志物,包括还原型谷胱甘肽和脂质过氧化氢水平,以及炎症参数,如髓过氧化物酶活性和亚硝酸盐水平,进行了分析。机制研究包括用n -乙基马来酰亚胺(NEM)、n -硝基-l-精氨酸甲酯(L-NAME)和吲哚美辛预处理小鼠。结果:ESTP 300 mg/kg口服和30 mg/kg腹腔注射可显著减轻乙醇/盐酸引起的胃损伤。它降低了脂质过氧化氢水平,但没有增加还原性谷胱甘肽的水平。髓过氧化物酶活性和亚硝酸盐水平降低。然而,ESTP没有恢复粘蛋白水平。吲哚美辛预处理可使ESTP的保护作用无效,而NEM和L-NAME则不能。结论:ESTP具有显著的胃保护作用,其表现为炎症和氧化介质的减少。观察到粘蛋白活性的下降,加上在吲哚美辛预处理后没有效果,表明提取物可能抑制环加氧酶活性。这些发现共同支持了该物种用于胃肠道保护的传统用途,并突出了其作为胃溃疡治疗药物的潜力。本文署名:Pegoraro Correa KG, do Carmo Barroso de Siqueira M, Zanovello M, Martins Belmudes M, de Souza P, Gasparotto Junior A, Boeing T. Talinum paniculatum (Jacq.)Gaertn。小鼠:民族药理学验证。集成医学[J];打印前Epub。
{"title":"Gastroprotective activity of Talinum paniculatum (Jacq.) Gaertn. in mice: An ethnopharmacological validation.","authors":"Kessy Gabrielly Pegoraro Correa, Marcella do Carmo Barroso de Siqueira, Mariana Zanovello, Manuela Martins Belmudes, Priscila de Souza, Arquimedes Gasparotto Junior, Thaise Boeing","doi":"10.1016/j.joim.2025.12.002","DOIUrl":"https://doi.org/10.1016/j.joim.2025.12.002","url":null,"abstract":"<p><strong>Objective: </strong>Gastric ulcers are a global health issue, often occurring in the stomach or duodenum and causing tissue necrosis. Talinum paniculatum (Jacq.) Gaertn (Erva-gorda) is used in traditional medicine for treating gastric ulcers. This study aimed to assess the gastroprotective effects of the ethanol-soluble fraction from T. paniculatum leaves (ESTP) in rodents.</p><p><strong>Methods: </strong>The gastroprotective potential of ESTP was evaluated at 30, 100, and 300 mg/kg taken orally, or 30 mg/kg intraperitoneally against gastric lesions induced by a 60% ethanol solution containing 0.3 mol/L hydrochloric acid, in mice. Histological sections were examined after hematoxylin-eosin staining and their mucin content was determined using the periodic acid-Schiff method. Oxidative stress markers, including levels of reduced glutathione and lipid hydroperoxide, as well as inflammatory parameters such as myeloperoxidase activity and nitrite levels, were analyzed. Mechanistic studies involved pretreating the mice with N-ethylmaleimide (NEM), N-nitro-l-arginine methyl ester (L-NAME), and indomethacin.</p><p><strong>Results: </strong>ESTP at 300 mg/kg orally and 30 mg/kg intraperitoneally significantly reduced ethanol/HCl-induced gastric injury. It decreased lipid hydroperoxide levels but did not increase levels of reduced glutathione. Myeloperoxidase activity and nitrite levels were reduced. However, ESTP did not restore mucin levels. Pretreatment with indomethacin nullified the protective effects of ESTP while NEM and L-NAME did not.</p><p><strong>Conclusion: </strong>ESTP demonstrated a remarkable gastroprotective effect, as indicated by reductions in inflammatory and oxidative mediators. The observed decline in mucin activity, coupled with the absence of an effect following indomethacin pretreatment, implies a potential inhibition of the cyclooxygenase activity by the extract. These findings collectively support the traditional use of the species for gastrointestinal protection and highlight its potential as a therapeutic agent for managing gastric ulcers. Please cite this article as: Pegoraro Correa KG, do Carmo Barroso de Siqueira M, Zanovello M, Martins Belmudes M, de Souza P, Gasparotto Junior A, Boeing T. Gastroprotective activity of Talinum paniculatum (Jacq.) Gaertn. in mice: An ethnopharmacological validation. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}