Pub Date : 2025-11-01DOI: 10.1016/j.joim.2025.08.004
Xin-ran Du , Meng-yi Wu , Mao-can Tao , Ying Lin , Chao-ying Gu , Min-feng Wu , Yi Cao , Da-can Chen , Wei Li , Hong-wei Wang , Ying Wang , Yi Wang , Han-zhi Lu , Xin Liu , Xiang-fei Su , Fu-lun Li
Traditional Chinese medicine (TCM) is a well-accepted therapy for atopic dermatitis (AD). However, there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD, limiting the clinical application of such combined approaches. Therefore, the China Association of Chinese Medicine initiated the development of the current guideline, focusing on key issues related to the use of TCM in the treatment of AD. This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization. A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted. The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine. This guideline comprises 23 recommendations across seven major areas, including TCM syndrome differentiation and classification of AD, principles and application scenarios of TCM combined with Western medicine for treating AD, outcome indicators for evaluating clinical efficacy of AD treatment, integration of TCM pattern classification and Western medicine across disease stages, daily management of AD, the use of internal TCM therapies and proprietary Chinese medicines, and TCM external treatments.
Please cite this article as: Du XR, Wu MY, Tao MC, Lin Y, Gu CY, Wu MF, Cao Y, Chen DC, Li W, Wang HW, Wang Y, Wang Y, Lu HZ, Liu X, Su XF, Li FL. Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine. J Integr Med. 2025; 23(6):641–653.
{"title":"Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine","authors":"Xin-ran Du , Meng-yi Wu , Mao-can Tao , Ying Lin , Chao-ying Gu , Min-feng Wu , Yi Cao , Da-can Chen , Wei Li , Hong-wei Wang , Ying Wang , Yi Wang , Han-zhi Lu , Xin Liu , Xiang-fei Su , Fu-lun Li","doi":"10.1016/j.joim.2025.08.004","DOIUrl":"10.1016/j.joim.2025.08.004","url":null,"abstract":"<div><div>Traditional Chinese medicine (TCM) is a well-accepted therapy for atopic dermatitis (AD). However, there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD, limiting the clinical application of such combined approaches. Therefore, the China Association of Chinese Medicine initiated the development of the current guideline, focusing on key issues related to the use of TCM in the treatment of AD. This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization. A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted. The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine. This guideline comprises 23 recommendations across seven major areas, including TCM syndrome differentiation and classification of AD, principles and application scenarios of TCM combined with Western medicine for treating AD, outcome indicators for evaluating clinical efficacy of AD treatment, integration of TCM pattern classification and Western medicine across disease stages, daily management of AD, the use of internal TCM therapies and proprietary Chinese medicines, and TCM external treatments.</div><div><br>Please cite this article as: Du XR, Wu MY, Tao MC, Lin Y, Gu CY, Wu MF, Cao Y, Chen DC, Li W, Wang HW, Wang Y, Wang Y, Lu HZ, Liu X, Su XF, Li FL. Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine. <em>J Integr Med</em>. 2025; 23(6):641–653.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 6","pages":"Pages 641-653"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041886","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 : 2025-11-01DOI: 10.1016/j.joim.2025.07.011
Xiao-chao Luo , Jia-li Liu , Ming-hong Yao , Ye-meng Chen , Arthur Yin Fan , Fan-rong Liang , Ji-ping Zhao , Ling Zhao , Xu Zhou , Xiao-ying Zhong , Jia-hui Yang , Bo Li , Ying Zhang , Xin Sun , Ling Li
Background
The use of inserted sham acupuncture as a placebo in randomized controlled trials (RCTs) is controversial, because it may produce specific effects that cause an underestimation of the effect of acupuncture treatment.
Objective
This systematic survey investigates the magnitude of insert-specific effects of sham acupuncture and whether they affect the estimation of acupuncture treatment effects.
Search strategy
PubMed, Embase and Cochrane Central Register of Controlled Trials were searched to identify acupuncture RCTs from their inception until December 2022.
Inclusion criteria
RCTs that evaluated the effects of acupuncture compared to sham acupuncture and no treatment.
Data extraction and analysis
The total effect measured for an acupuncture treatment group in RCTs were divided into three components, including the natural history and/or regression to the mean effect (controlled for no-treatment group), the placebo effect, and the specific effect of acupuncture. The first two constituted the contextual effect of acupuncture, which is mimicked by a sham acupuncture treatment group. The proportion of acupuncture total effect size was considered to be 1. The proportion of natural history and/or regression to the mean effect (PNE) and proportional contextual effect (PCE) of included RCTs were pooled using meta-analyses with a random-effect model. The proportion of acupuncture placebo effect was the difference between PCE and PNE in RCTs with non-inserted sham acupuncture. The proportion of insert-specific effect of sham acupuncture (PIES) was obtained by subtracting the proportion of acupuncture placebo effect and PNE from PCE in RCTs with inserted sham acupuncture. The impact of PIES on the estimation of acupuncture’s treatment effect was evaluated by quantifying the percentage of RCTs that the effect of outcome changed from no statistical difference to statistical difference after removing PIES in the included studies, and the impact of PIES was externally validated in other acupuncture RCTs with an inserted sham acupuncture group that were not used to calculate PIES.
Results
This analysis included 32 studies with 5492 patients. The overall PNE was 0.335 (95% confidence interval [CI], 0.255–0.415) and the PCE of acupuncture was 0.639 (95% CI, 0.567–0.710) of acupuncture’s total effect. The proportional contribution of the placebo effect to acupuncture’s total effect was 0.191, and the PIES was 0.189. When we modeled the exclusion of the insert-specific effect of sham acupuncture, the acupuncture treatment effect changed from no difference to a significant difference in 45.45% of the included RCTs, and in 40.91% of the external validated RCTs.
Conclusion
The insert-specific effect of sham acupuncture in RCTs represents 18.90% of acupuncture’s total eff
{"title":"Specific effect of inserted sham acupuncture and its impact on the estimation of acupuncture treatment effect in randomized controlled trials: A systematic survey","authors":"Xiao-chao Luo , Jia-li Liu , Ming-hong Yao , Ye-meng Chen , Arthur Yin Fan , Fan-rong Liang , Ji-ping Zhao , Ling Zhao , Xu Zhou , Xiao-ying Zhong , Jia-hui Yang , Bo Li , Ying Zhang , Xin Sun , Ling Li","doi":"10.1016/j.joim.2025.07.011","DOIUrl":"10.1016/j.joim.2025.07.011","url":null,"abstract":"<div><h3>Background</h3><div>The use of inserted sham acupuncture as a placebo in randomized controlled trials (RCTs) is controversial, because it may produce specific effects that cause an underestimation of the effect of acupuncture treatment.</div></div><div><h3>Objective</h3><div>This systematic survey investigates the magnitude of insert-specific effects of sham acupuncture and whether they affect the estimation of acupuncture treatment effects.</div></div><div><h3>Search strategy</h3><div>PubMed, Embase and Cochrane Central Register of Controlled Trials were searched to identify acupuncture RCTs from their inception until December 2022.</div></div><div><h3>Inclusion criteria</h3><div>RCTs that evaluated the effects of acupuncture compared to sham acupuncture and no treatment.</div></div><div><h3>Data extraction and analysis</h3><div>The total effect measured for an acupuncture treatment group in RCTs were divided into three components, including the natural history and/or regression to the mean effect (controlled for no-treatment group), the placebo effect, and the specific effect of acupuncture. The first two constituted the contextual effect of acupuncture, which is mimicked by a sham acupuncture treatment group. The proportion of acupuncture total effect size was considered to be 1. The proportion of natural history and/or regression to the mean effect (PNE) and proportional contextual effect (PCE) of included RCTs were pooled using meta-analyses with a random-effect model. The proportion of acupuncture placebo effect was the difference between PCE and PNE in RCTs with non-inserted sham acupuncture. The proportion of insert-specific effect of sham acupuncture (PIES) was obtained by subtracting the proportion of acupuncture placebo effect and PNE from PCE in RCTs with inserted sham acupuncture. The impact of PIES on the estimation of acupuncture’s treatment effect was evaluated by quantifying the percentage of RCTs that the effect of outcome changed from no statistical difference to statistical difference after removing PIES in the included studies, and the impact of PIES was externally validated in other acupuncture RCTs with an inserted sham acupuncture group that were not used to calculate PIES.</div></div><div><h3>Results</h3><div>This analysis included 32 studies with 5492 patients. The overall PNE was 0.335 (95% confidence interval [CI], 0.255–0.415) and the PCE of acupuncture was 0.639 (95% CI, 0.567–0.710) of acupuncture’s total effect. The proportional contribution of the placebo effect to acupuncture’s total effect was 0.191, and the PIES was 0.189. When we modeled the exclusion of the insert-specific effect of sham acupuncture, the acupuncture treatment effect changed from no difference to a significant difference in 45.45% of the included RCTs, and in 40.91% of the external validated RCTs.</div></div><div><h3>Conclusion</h3><div>The insert-specific effect of sham acupuncture in RCTs represents 18.90% of acupuncture’s total eff","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 6","pages":"Pages 630-640"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838309","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 : 2025-11-01DOI: 10.1016/j.joim.2025.07.010
Xuan Zhang , Lin Zhang , Juan Wang , Chung Tai Lau , Nana Wang , Xuanqi Zhang , Ping Wang , Ji Li , Fei Han , Zhaoxiang Bian
To improve the consistency of outcome documentation and address the potential for outcome reporting bias in clinical trials involving integrative Chinese and Western medicine (ICWM) for ulcerative colitis (UC), we aim to develop a customized core outcome set (COS) that incorporates input from various stakeholders. The study design of this COS has been informed by the Core Outcome Measures in Effectiveness Trials Initiative Handbook, with adherence to the guidelines from the Core Outcome Set—STAndards for Reporting statement and Core Outcome Set—STAndardised Protocol Items recommendations. Five groups of stakeholders will be invited to participate in the development of COS for clinical trials with ICWM for UC, including healthcare professionals, patients, COS developers, COS users, and methodologists. The process will involve five stages: (1) conducting a systematic review of outcomes reported in clinical trials and protocols to develop a list of potential outcome domains; (2) conducting semi-structured interviews to obtain important outcomes; (3) choosing the most important outcomes by conducting three-round Delphi surveys; (4) achieving a consensus in a face-to-face meeting to discuss the final COS; and (5) publication, dissemination and implementation of COS. Consequently, this specialized COS will be applicable to clinical trials involving both traditional Chinese medicine (TCM) and ICWM interventions.
Please cite this article as: Zhang X, Zhang L, Wang J, Lau CT, Wang N, Zhang X, Wang P, Li J, Han F, Bian Z. A protocol for developing, disseminating and implementing a core outcome set for clinical trials of integrative Chinese and Western medicine for ulcerative colitis. J Integr Med. 2025; 23(6):654–659.
{"title":"A protocol for developing, disseminating and implementing a core outcome set for clinical trials of integrative Chinese and Western medicine for ulcerative colitis","authors":"Xuan Zhang , Lin Zhang , Juan Wang , Chung Tai Lau , Nana Wang , Xuanqi Zhang , Ping Wang , Ji Li , Fei Han , Zhaoxiang Bian","doi":"10.1016/j.joim.2025.07.010","DOIUrl":"10.1016/j.joim.2025.07.010","url":null,"abstract":"<div><div>To improve the consistency of outcome documentation and address the potential for outcome reporting bias in clinical trials involving integrative Chinese and Western medicine (ICWM) for ulcerative colitis (UC), we aim to develop a customized core outcome set (COS) that incorporates input from various stakeholders. The study design of this COS has been informed by the Core Outcome Measures in Effectiveness Trials Initiative Handbook, with adherence to the guidelines from the Core Outcome Set—STAndards for Reporting statement and Core Outcome Set—STAndardised Protocol Items recommendations. Five groups of stakeholders will be invited to participate in the development of COS for clinical trials with ICWM for UC, including healthcare professionals, patients, COS developers, COS users, and methodologists. The process will involve five stages: (1) conducting a systematic review of outcomes reported in clinical trials and protocols to develop a list of potential outcome domains; (2) conducting semi-structured interviews to obtain important outcomes; (3) choosing the most important outcomes by conducting three-round Delphi surveys; (4) achieving a consensus in a face-to-face meeting to discuss the final COS; and (5) publication, dissemination and implementation of COS. Consequently, this specialized COS will be applicable to clinical trials involving both traditional Chinese medicine (TCM) and ICWM interventions.</div><div><br>Please cite this article as: Zhang X, Zhang L, Wang J, Lau CT, Wang N, Zhang X, Wang P, Li J, Han F, Bian Z. A protocol for developing, disseminating and implementing a core outcome set for clinical trials of integrative Chinese and Western medicine for ulcerative colitis. <em>J Integr Med</em>. 2025; 23(6):654–659.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 6","pages":"Pages 654-659"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838308","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 : 2025-11-01DOI: 10.1016/j.joim.2025.08.001
Meng-qi Li , Yan Li , Winsome Lam , Wing Fai Yeung , Yuen Shan Ho , Jia-ying Li , Tsz Ching Sun , Sam Yuen , Yu-le Hu , Jannelle Yorke
Background
Spinal cord injury (SCI) survivors often experience constipation, which contributes to a reduced sense of well-being and a lower quality of life. Acupressure offers a non-pharmacological and non-invasive alternative therapy for treating constipation.
Objective
This study examined the effects of home-based acupressure on constipation and subjective well-being among SCI survivors.
Design, setting, participants and interventions
This randomized controlled trial randomly assigned 80 adults from Hong Kong with SCI to two study groups. Using a video demonstration filmed by a registered traditional Chinese medicine practitioner, the intervention group performed home-based acupressure (self-administered or caregiver-assisted) twice daily, 15 min/session, for 10 consecutive days. The control group performed manual light touching of the abdomen with the same frequency and duration as the intervention group. Both groups received defecation education through a structured booklet.
Main outcomes measures
The primary outcome was constipation severity. Secondary outcomes included bowel habits, psychological well-being, and quality of life. Focus group interviews were conducted after the intervention to collect subjective feedback from participants.
Results
Significant group-by-time interaction effects on constipation severity (P = 0.005) and quality of life (P = 0.001) revealed that home-based acupressure produced better results than the control. These treatment effects persisted at the one-month follow-up and continued to have a large effect size (Cohen’s d > 0.8). Compared to the control group, the acupressure group also had improvements in anxiety (Cohen’s d = 0.69) and depression (Cohen’s d = 0.72) at the end of the intervention period. Three qualitative categories were identified from the focus group interviews: improvements in bowel function and management; reduced psychological distress following relief from constipation; and acceptability of home-based acupressure.
Conclusion
Acupressure effectively relieves constipation, enhances psychological well-being, and improves quality of life in people with SCI. These data provide novel evidence supporting the use of home-based acupressure as an acceptable and effective therapy for treating constipation after SCI.
Please cite this article as: Li MQ, Li Y, Lam W, Yeung WF, Ho YS, Li JY, Sun TC, Yuen S, Hu YL, Yorke J. Home-based acupressure for managing constipation and subjective well-being in spinal cord injury survivors: A randomized controlled trial. J Integr Med. 2025; 23(6):660–669.
背景：脊髓损伤（SCI）幸存者经常经历便秘，这有助于降低幸福感和生活质量。穴位按压为治疗便秘提供了一种非药物和非侵入性的替代疗法。目的：本研究探讨了家庭穴位按压对脊髓损伤幸存者便秘和主观幸福感的影响。设计、环境、参与者和干预措施：本随机对照试验将80名香港脊髓损伤成人随机分为两个研究组。干预组使用由注册中医拍摄的视频演示，每天两次，每次15分钟，连续10天进行家庭穴位按压（自我管理或护理人员协助）。对照组采用与干预组相同的频率和持续时间，对腹部进行手工轻触。两组都通过一本有组织的小册子接受了排便教育。主要结局指标：主要结局为便秘严重程度。次要结果包括排便习惯、心理健康和生活质量。干预后进行焦点小组访谈，收集参与者的主观反馈。结果：组间交互作用对便秘严重程度（P = 0.005）和生活质量（P = 0.001）有显著影响，表明家庭穴位按压治疗效果优于对照组。这些治疗效果在一个月的随访中持续存在，并继续具有较大的效应量（Cohen's d = 0.8）。与对照组相比，穴位按压组在干预期结束时焦虑（Cohen’s d = 0.69）和抑郁（Cohen’s d = 0.72）方面也有改善。从焦点小组访谈中确定了三个定性类别：肠道功能和管理的改善；减轻便秘后的心理困扰；以及家庭穴位按摩的可接受性。结论：穴位按压可有效缓解脊髓损伤患者便秘，增强心理健康，改善生活质量。这些数据提供了新的证据，支持使用家庭穴位按压作为治疗脊髓损伤后便秘的一种可接受和有效的治疗方法。试验注册：ClinicalTrials.gov （NCT05558657）。李明明，李勇，林伟，杨文峰，何玉云，李建勇，孙振东，袁生，胡玉玲，Yorke J.家庭穴位按摩治疗脊髓损伤幸存者便秘和主观幸福感：一项随机对照试验。集成医学[J]；打印前Epub。
{"title":"Home-based acupressure for managing constipation and subjective well-being in spinal cord injury survivors: A randomized controlled trial","authors":"Meng-qi Li , Yan Li , Winsome Lam , Wing Fai Yeung , Yuen Shan Ho , Jia-ying Li , Tsz Ching Sun , Sam Yuen , Yu-le Hu , Jannelle Yorke","doi":"10.1016/j.joim.2025.08.001","DOIUrl":"10.1016/j.joim.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Spinal cord injury (SCI) survivors often experience constipation, which contributes to a reduced sense of well-being and a lower quality of life. Acupressure offers a non-pharmacological and non-invasive alternative therapy for treating constipation.</div></div><div><h3>Objective</h3><div>This study examined the effects of home-based acupressure on constipation and subjective well-being among SCI survivors.</div></div><div><h3>Design, setting, participants and interventions</h3><div>This randomized controlled trial randomly assigned 80 adults from Hong Kong with SCI to two study groups. Using a video demonstration filmed by a registered traditional Chinese medicine practitioner, the intervention group performed home-based acupressure (self-administered or caregiver-assisted) twice daily, 15 min/session, for 10 consecutive days. The control group performed manual light touching of the abdomen with the same frequency and duration as the intervention group. Both groups received defecation education through a structured booklet.</div></div><div><h3>Main outcomes measures</h3><div>The primary outcome was constipation severity. Secondary outcomes included bowel habits, psychological well-being, and quality of life. Focus group interviews were conducted after the intervention to collect subjective feedback from participants.</div></div><div><h3>Results</h3><div>Significant group-by-time interaction effects on constipation severity (<em>P</em> = 0.005) and quality of life (<em>P</em> = 0.001) revealed that home-based acupressure produced better results than the control. These treatment effects persisted at the one-month follow-up and continued to have a large effect size (Cohen’s <em>d</em> > 0.8). Compared to the control group, the acupressure group also had improvements in anxiety (Cohen’s <em>d</em> = 0.69) and depression (Cohen’s <em>d</em> = 0.72) at the end of the intervention period. Three qualitative categories were identified from the focus group interviews: improvements in bowel function and management; reduced psychological distress following relief from constipation; and acceptability of home-based acupressure.</div></div><div><h3>Conclusion</h3><div>Acupressure effectively relieves constipation, enhances psychological well-being, and improves quality of life in people with SCI. These data provide novel evidence supporting the use of home-based acupressure as an acceptable and effective therapy for treating constipation after SCI.</div><div><em>Trial registration:</em> <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT05558657).</div><div><br> Please cite this article as: Li MQ, Li Y, Lam W, Yeung WF, Ho YS, Li JY, Sun TC, Yuen S, Hu YL, Yorke J. Home-based acupressure for managing constipation and subjective well-being in spinal cord injury survivors: A randomized controlled trial. <em>J Integr Med</em>. 2025; 23(6):660–669.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 6","pages":"Pages 660-669"},"PeriodicalIF":4.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975129","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}
<p><strong>Background: </strong>Sham acupuncture is commonly used as a control in clinical acupuncture trials. However, its placebo effects remain unclear, and there is no standardized protocol regarding stimulation intensity or needling location.</p><p><strong>Objective: </strong>Using randomized controlled trials (RCTs) of acupuncture for insomnia as an example, this study aimed to evaluate the placebo effect of sham acupuncture and to analyze how stimulation intensity and acupoint location influence this effect.</p><p><strong>Search strategy: </strong>A comprehensive search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, and Chinese Scientific Journals Database from the inception until January 25, 2025.</p><p><strong>Inclusion criteria: </strong>Eligible studies were RCTs involving participants diagnosed with insomnia or other sleep disorders that compared acupuncture to sham acupuncture. No restrictions were placed on disease duration or severity.</p><p><strong>Data extraction and analysis: </strong>Primary outcome measures were Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Secondary outcomes included total sleep time, sleep efficiency, sleep awakening time, and PSQI scores at a 4-week follow-up. Studies reporting at least one primary outcome were eligible for inclusion. For continuous outcomes, mean difference (MD) with 95% confidence interval (CI) were calculated. When measurement units were inconsistent or outcome variability was high, standardized MD (SMD) and 95% CI were calculated. Pairwise meta-analyses were conducted using Review Manager 5.4, while network meta-analyses were performed using Stata 16. The risk of bias was assessed using the Cochrane risk of bias tool.</p><p><strong>Results: </strong>A total of 15 RCTs involving 609 participants were included. Compared to baseline, sham acupuncture significantly improved PSQI scores (MD = 1.43; 95% CI: [0.91, 1.94]; P < 0.0001; I<sup>2</sup> = 61%) and sleep efficiency (MD = -2.53; 95% CI: [-4.77, -0.29]; P = 0.03; I<sup>2</sup> = 91%). Subgroup analysis revealed that low-intensity stimulation and medium-frequency treatment (13-20 sessions) were associated with stronger placebo effects. The network meta-analysis suggested a potential interaction between stimulation intensity and treatment location. Among all subgroups, sham acupuncture performed at non-meridian, non-acupoint locations using low-intensity stimulation produced the greatest placebo effects in terms of PSQI improvement, ISI reduction, and prolongation of sleep duration, achieving the highest value of surface under the cumulative ranking curve.</p><p><strong>Conclusion: </strong>Sham acupuncture produces a measurable and relatively stable placebo effect in insomnia patients. The effectiveness varied across different sham protocols, with low-intensity stimulation and medium-frequency regimens (13-20 sessions) showing
{"title":"Placebo effect of sham acupuncture in patients with insomnia and influence of varying stimulation intensities and locations: A systematic review and meta-analysis.","authors":"Jing-Ying Chi, Rui-Xin Zhu, Cheng Chen, Run-Lei Xu, Chang-Zi Lyu, Ji-Xuan Yao, Man-Qian Fu, De-Jun Wang, Ge-Shu Du","doi":"10.1016/j.joim.2025.10.006","DOIUrl":"https://doi.org/10.1016/j.joim.2025.10.006","url":null,"abstract":"<p><strong>Background: </strong>Sham acupuncture is commonly used as a control in clinical acupuncture trials. However, its placebo effects remain unclear, and there is no standardized protocol regarding stimulation intensity or needling location.</p><p><strong>Objective: </strong>Using randomized controlled trials (RCTs) of acupuncture for insomnia as an example, this study aimed to evaluate the placebo effect of sham acupuncture and to analyze how stimulation intensity and acupoint location influence this effect.</p><p><strong>Search strategy: </strong>A comprehensive search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, and Chinese Scientific Journals Database from the inception until January 25, 2025.</p><p><strong>Inclusion criteria: </strong>Eligible studies were RCTs involving participants diagnosed with insomnia or other sleep disorders that compared acupuncture to sham acupuncture. No restrictions were placed on disease duration or severity.</p><p><strong>Data extraction and analysis: </strong>Primary outcome measures were Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Secondary outcomes included total sleep time, sleep efficiency, sleep awakening time, and PSQI scores at a 4-week follow-up. Studies reporting at least one primary outcome were eligible for inclusion. For continuous outcomes, mean difference (MD) with 95% confidence interval (CI) were calculated. When measurement units were inconsistent or outcome variability was high, standardized MD (SMD) and 95% CI were calculated. Pairwise meta-analyses were conducted using Review Manager 5.4, while network meta-analyses were performed using Stata 16. The risk of bias was assessed using the Cochrane risk of bias tool.</p><p><strong>Results: </strong>A total of 15 RCTs involving 609 participants were included. Compared to baseline, sham acupuncture significantly improved PSQI scores (MD = 1.43; 95% CI: [0.91, 1.94]; P < 0.0001; I<sup>2</sup> = 61%) and sleep efficiency (MD = -2.53; 95% CI: [-4.77, -0.29]; P = 0.03; I<sup>2</sup> = 91%). Subgroup analysis revealed that low-intensity stimulation and medium-frequency treatment (13-20 sessions) were associated with stronger placebo effects. The network meta-analysis suggested a potential interaction between stimulation intensity and treatment location. Among all subgroups, sham acupuncture performed at non-meridian, non-acupoint locations using low-intensity stimulation produced the greatest placebo effects in terms of PSQI improvement, ISI reduction, and prolongation of sleep duration, achieving the highest value of surface under the cumulative ranking curve.</p><p><strong>Conclusion: </strong>Sham acupuncture produces a measurable and relatively stable placebo effect in insomnia patients. The effectiveness varied across different sham protocols, with low-intensity stimulation and medium-frequency regimens (13-20 sessions) showing ","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459988","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 : 2025-10-15DOI: 10.1016/j.joim.2025.10.005
Lei-Lei Chen, Wen-Jing Zhai, Juan Bao, Zheng-Hao Yu, Tian-Yi Zhang, Xue-Chun Lu, Lin Liu, Li Chen, Su-Yang Wang, Jing Hu, Xin Gao, Qi Zhang, Guo-Gang Xu, Hai-Li Xin
Objective: Limited data are available on the use of antiviral drugs among oldest-old patients. This study investigates the effect of Jinhua Qinggan Granule (JHQG), a compound Chinese herbal medicine, on the efficacy and safety of nirmatrelvir/ritonavir in oldest-old patients with coronavirus disease 2019 (COVID-19).
Methods: A total of 180 oldest-old patients with confirmed COVID-19 at the Chinese PLA General Hospital from July 2023 to July 2024 were enrolled in this retrospective cohort study and were divided into a monotherapy group (nirmatrelvir/ritonavir, n = 89) and a combination therapy group (nirmatrelvir/ritonavir plus JHQG, n = 91) according to the treatments received. The primary outcome was the cumulative rate of nucleic acid negative conversion (NANC) on the fifth day after initiation of treatment. The secondary outcomes included the rates of improvement in the main symptoms, the duration of fever, and variations in clinical laboratory indices. The safety outcomes included the incidence of adverse drug reactions (ADRs) and indicators of liver and kidney function.
Results: Among the 180 oldest-old patients participating in the study, the median (P25, P75) age was 93.0 (86.0, 96.0) years, and 94.44% were male. The rate of NANC within five days was significantly higher in the combination therapy group than in the monotherapy group (80.22% vs 66.29%, P = 0.035). The addition of JHQG was significantly associated with NANC within five days in the multivariable analysis (odds ratio [OR] = 2.216; 95% confidence interval [CI]: 1.066-4.607; P = 0.033). Furthermore, compared with nirmatrelvir/ritonavir alone, combination therapy had better effects on the recovery rates of various symptoms, including fever, cough, expectoration, and all respiratory symptoms, as well as the time to recovery from fever (P < 0.05). There were also significant differences between the two groups in terms of improvement in C-reactive protein (P < 0.05). Moreover, no significant differences were observed in the incidence of ADRs or in liver and kidney function indicators (P > 0.05).
Conclusion: Among oldest-old patients with COVID-19, the addition of JHQG to nirmatrelvir/ritonavir significantly improves early clinical recovery without increasing safety concerns. Please cite this article as: Chen LL, Zhai WJ, Bao J, Yu ZH, Zhang TY, Lu XC, Liu L, Chen L, Wang SY, Hu J, Gao X, Zhang Q, Xu GG, Xin HL. Efficacy and safety of Jinhua Qinggan Granule, a compound Chinese herbal medicine, in oldest-old patients with COVID-19: A retrospective cohort study. J Integr Med. 2025.
目的：关于老年患者使用抗病毒药物的数据有限。本研究探讨复方中草药金花清肝颗粒（JHQG）对尼马特利韦/利托那韦治疗老年冠状病毒病2019 （COVID-19）患者的疗效和安全性的影响。方法：选取2023年7月至2024年7月在中国人民解放军总医院就诊的老年确诊COVID-19患者180例进行回顾性队列研究，根据治疗方案分为单药治疗组（尼马泰利韦/利托那韦，n = 89）和联合治疗组（尼马泰利韦/利托那韦+ JHQG， n = 91）。主要观察指标为开始治疗后第5天的累积核酸阴性转化率（NANC）。次要结局包括主要症状的改善率、发烧持续时间和临床实验室指标的变化。安全性指标包括药物不良反应（adr）发生率和肝肾功能指标。结果：参与研究的180例老年患者中，年龄中位数（P25, P75）为93.0（86.0,96.0）岁，男性占94.44%。联合治疗组5 d内NANC发生率显著高于单药组（80.22% vs 66.29%, P = 0.035）。在多变量分析中，加入JHQG与5天内的NANC显著相关（优势比[OR] = 2.216； 95%可信区间[CI]: 1.066 ~ 4.607; P = 0.033）。与单用尼马特利韦/利托那韦治疗相比，联合治疗对发热、咳嗽、咳痰及所有呼吸道症状的恢复率及发热恢复时间均有更好的效果（P < 0.05）。结论：在老年COVID-19患者中，JHQG联合尼马特利韦/利托那韦可显著改善早期临床恢复，且不增加安全性担忧。本文署名：陈丽丽，翟文杰，鲍杰，于铮，张泰，卢晓晨，刘丽，陈丽，王世义，胡静，高翔，张强，徐国光，辛海林。复方中草药金花清肝颗粒对老年新冠肺炎患者疗效及安全性的回顾性队列研究[J] .集成医学。2025。
{"title":"Efficacy and safety of Jinhua Qinggan Granule, a compound Chinese herbal medicine, in oldest-old patients with COVID-19: A retrospective cohort study.","authors":"Lei-Lei Chen, Wen-Jing Zhai, Juan Bao, Zheng-Hao Yu, Tian-Yi Zhang, Xue-Chun Lu, Lin Liu, Li Chen, Su-Yang Wang, Jing Hu, Xin Gao, Qi Zhang, Guo-Gang Xu, Hai-Li Xin","doi":"10.1016/j.joim.2025.10.005","DOIUrl":"https://doi.org/10.1016/j.joim.2025.10.005","url":null,"abstract":"<p><strong>Objective: </strong>Limited data are available on the use of antiviral drugs among oldest-old patients. This study investigates the effect of Jinhua Qinggan Granule (JHQG), a compound Chinese herbal medicine, on the efficacy and safety of nirmatrelvir/ritonavir in oldest-old patients with coronavirus disease 2019 (COVID-19).</p><p><strong>Methods: </strong>A total of 180 oldest-old patients with confirmed COVID-19 at the Chinese PLA General Hospital from July 2023 to July 2024 were enrolled in this retrospective cohort study and were divided into a monotherapy group (nirmatrelvir/ritonavir, n = 89) and a combination therapy group (nirmatrelvir/ritonavir plus JHQG, n = 91) according to the treatments received. The primary outcome was the cumulative rate of nucleic acid negative conversion (NANC) on the fifth day after initiation of treatment. The secondary outcomes included the rates of improvement in the main symptoms, the duration of fever, and variations in clinical laboratory indices. The safety outcomes included the incidence of adverse drug reactions (ADRs) and indicators of liver and kidney function.</p><p><strong>Results: </strong>Among the 180 oldest-old patients participating in the study, the median (P25, P75) age was 93.0 (86.0, 96.0) years, and 94.44% were male. The rate of NANC within five days was significantly higher in the combination therapy group than in the monotherapy group (80.22% vs 66.29%, P = 0.035). The addition of JHQG was significantly associated with NANC within five days in the multivariable analysis (odds ratio [OR] = 2.216; 95% confidence interval [CI]: 1.066-4.607; P = 0.033). Furthermore, compared with nirmatrelvir/ritonavir alone, combination therapy had better effects on the recovery rates of various symptoms, including fever, cough, expectoration, and all respiratory symptoms, as well as the time to recovery from fever (P < 0.05). There were also significant differences between the two groups in terms of improvement in C-reactive protein (P < 0.05). Moreover, no significant differences were observed in the incidence of ADRs or in liver and kidney function indicators (P > 0.05).</p><p><strong>Conclusion: </strong>Among oldest-old patients with COVID-19, the addition of JHQG to nirmatrelvir/ritonavir significantly improves early clinical recovery without increasing safety concerns. Please cite this article as: Chen LL, Zhai WJ, Bao J, Yu ZH, Zhang TY, Lu XC, Liu L, Chen L, Wang SY, Hu J, Gao X, Zhang Q, Xu GG, Xin HL. Efficacy and safety of Jinhua Qinggan Granule, a compound Chinese herbal medicine, in oldest-old patients with COVID-19: A retrospective cohort study. J Integr Med. 2025.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472132","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 : 2025-10-13DOI: 10.1016/j.joim.2025.10.002
Pei-Pei Qin, Ke Wei, Bing-Yu Zou, Dan Liu, Ming-Xi Li, Xiao-Nan Liu, Lei Zou, Bin Wu
<p><strong>Background: </strong>Optimizing analgesia following caesarean section is essential for improving maternal rehabilitation and fostering maternal-infant bonding.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the safety and effectiveness of transcutaneous electrical acupoint stimulation (TEAS) combined with press needle therapy as an adjunctive approach for postoperative pain control following caesarean section.</p><p><strong>Design, setting, participants and interventions: </strong>One hundred women with singleton term pregnancies who were schedule to undergo caesarean section births under combined spinal-epidural anesthesia were recruited. Patients were randomly assigned to the acupuncture group (n = 50) or sham-acupuncture group (n = 50). The acupuncture group received pre- and intraoperative TEAS combined with postoperative press needle therapy. The sham-acupuncture group received a sham acupuncture intervention.</p><p><strong>Main outcome measures: </strong>The primary outcome was total cumulative morphine consumption at 48 h. Secondary outcomes included pain scores, morphine consumption and patient satisfaction. Analgesic-related adverse effects and acupuncture-related side effects were recorded.</p><p><strong>Results: </strong>Overall, 100 patients were included in the intention-to-treat analysis. Median (interquartile range [range]) of cumulative morphine consumption at 48 h in the acupuncture group was lower than that in the sham-acupuncture group (22.9 [16.9-28.9] mg vs 34.9 [22.4-39.4] mg), with an estimated median difference of -10.0 mg (95% confidence interval, [-14.0, -4.0]; P < 0.001). The generalized estimating equation analysis also revealed that cumulative morphine consumption was significantly lower in the acupuncture group than in the sham-acupuncture group at 6, 12 and 24 h (P < 0.001). In addition, patients in the acupuncture group reported lower pain scores both at rest and during movement at 6, 12 and 24 h compared to those in the sham-acupuncture group (P < 0.001). Furthermore, acupuncture improved patient satisfaction (P < 0.001) and decreased the incidence of nausea and vomiting after surgery (12% vs 30%; P = 0.03). None of the patients in the study experienced any acupuncture-related side effects.</p><p><strong>Conclusion: </strong>As a non-pharmacological approach, TEAS combined with press needle therapy safely and effectively reduced postoperative morphine consumption and alleviated postoperative pain in women who underwent caesarean sections, recommending it as a routine complementary treatment for postpartum analgesia.</p><p><strong>Trial registration: </strong>The protocol was registered at the Chinese Clinical Trial Registry (ChiCTR2400086645). Please cite this article as: Qin PP, Wei K, Zou BY, Liu D, Li MX, Liu XN, Zou L, Wu B. Effectiveness of transcutaneous electrical acupoint stimulation combined with press needle therapy for pain control after caesarean section: A rando
{"title":"Effectiveness of transcutaneous electrical acupoint stimulation combined with press needle therapy for pain control after caesarean section: A randomized controlled trial.","authors":"Pei-Pei Qin, Ke Wei, Bing-Yu Zou, Dan Liu, Ming-Xi Li, Xiao-Nan Liu, Lei Zou, Bin Wu","doi":"10.1016/j.joim.2025.10.002","DOIUrl":"https://doi.org/10.1016/j.joim.2025.10.002","url":null,"abstract":"<p><strong>Background: </strong>Optimizing analgesia following caesarean section is essential for improving maternal rehabilitation and fostering maternal-infant bonding.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the safety and effectiveness of transcutaneous electrical acupoint stimulation (TEAS) combined with press needle therapy as an adjunctive approach for postoperative pain control following caesarean section.</p><p><strong>Design, setting, participants and interventions: </strong>One hundred women with singleton term pregnancies who were schedule to undergo caesarean section births under combined spinal-epidural anesthesia were recruited. Patients were randomly assigned to the acupuncture group (n = 50) or sham-acupuncture group (n = 50). The acupuncture group received pre- and intraoperative TEAS combined with postoperative press needle therapy. The sham-acupuncture group received a sham acupuncture intervention.</p><p><strong>Main outcome measures: </strong>The primary outcome was total cumulative morphine consumption at 48 h. Secondary outcomes included pain scores, morphine consumption and patient satisfaction. Analgesic-related adverse effects and acupuncture-related side effects were recorded.</p><p><strong>Results: </strong>Overall, 100 patients were included in the intention-to-treat analysis. Median (interquartile range [range]) of cumulative morphine consumption at 48 h in the acupuncture group was lower than that in the sham-acupuncture group (22.9 [16.9-28.9] mg vs 34.9 [22.4-39.4] mg), with an estimated median difference of -10.0 mg (95% confidence interval, [-14.0, -4.0]; P < 0.001). The generalized estimating equation analysis also revealed that cumulative morphine consumption was significantly lower in the acupuncture group than in the sham-acupuncture group at 6, 12 and 24 h (P < 0.001). In addition, patients in the acupuncture group reported lower pain scores both at rest and during movement at 6, 12 and 24 h compared to those in the sham-acupuncture group (P < 0.001). Furthermore, acupuncture improved patient satisfaction (P < 0.001) and decreased the incidence of nausea and vomiting after surgery (12% vs 30%; P = 0.03). None of the patients in the study experienced any acupuncture-related side effects.</p><p><strong>Conclusion: </strong>As a non-pharmacological approach, TEAS combined with press needle therapy safely and effectively reduced postoperative morphine consumption and alleviated postoperative pain in women who underwent caesarean sections, recommending it as a routine complementary treatment for postpartum analgesia.</p><p><strong>Trial registration: </strong>The protocol was registered at the Chinese Clinical Trial Registry (ChiCTR2400086645). Please cite this article as: Qin PP, Wei K, Zou BY, Liu D, Li MX, Liu XN, Zou L, Wu B. Effectiveness of transcutaneous electrical acupoint stimulation combined with press needle therapy for pain control after caesarean section: A rando","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670410","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 : 2025-10-13DOI: 10.1016/j.joim.2025.10.003
Paulo Alexandre Pereira, Carlos Miguel Marto, Bárbara Oliveiros, Maria Filomena Botelho
<p><strong>Background: </strong>Migraine is a highly prevalent primary headache disorder that impacts individuals and societies around the globe. Acupuncture can be used in migraine treatment and prevention due to its analgesic effects, safety profile, and modulation of neural pathways. However, there is a lack of conclusive evidence, and some reports present conflicting results.</p><p><strong>Objective: </strong>The aim of this umbrella review is to evaluate the effectiveness of acupuncture in migraine treatment, comparing it to the standard pharmacological treatment.</p><p><strong>Search strategy: </strong>MEDLINE (via PubMed), Embase, Web of Science (all databases), Cochrane, and Epistemonikos databases were searched for articles published prior to February 2024 in English, Portuguese, French and Spanish, and no date restriction was applied.</p><p><strong>Inclusion criteria: </strong>Systematic reviews, with or without meta-analysis, of randomized controlled trials, comparing acupuncture with standard pharmacological treatment were included. Patients of all ages diagnosed with episodic or chronic migraine, with or without aura, according to international guidelines were included. The main outcome was the pain intensity. Secondary outcomes included days with migraine per month, response rate, quality of life, dropout rate, use of rescue medication, and adverse events.</p><p><strong>Data extraction and analysis: </strong>Articles were initially evaluated based on the title and abstract, and later based on the full text, independently by two reviewers. For the meta-analysis, data were extracted from the primary studies, and a random effects model was used. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool and the degree of overlap was also evaluated. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Twenty-two reviews encompassing 24,635 patients were included. Most systematic reviews reported greater improvements and better tolerability in the acupuncture group. The meta-analysis showed a statistically significant reduction in pain intensity (standard mean difference [SMD]: -2.17; 95% confidence interval [CI] [-3.25; -1.10]; P < 0.001) and in days with migraine per month (SMD: -2.92; 95% CI [-4.65; -1.20]; P < 0.001), both favoring acupuncture, but high heterogeneity among results was found. Subgroup analysis confirmed that this reduction persisted at 3 months after cessation of treatment. However, the outcome variables for response to treatment and occurrence of adverse events did not meet the threshold for statistical significance. The quality of included reviews was low to moderate, and the degree of overlap was considered moderate.</p><p><strong>Conclusion: </strong>Acupuncture is a safe and effective alternative to medication for migraine. It should be considered as a preventive treatmen
背景：偏头痛是一种非常普遍的原发性头痛疾病，影响着全球的个人和社会。针灸可用于偏头痛的治疗和预防，因为它的镇痛作用，安全性和神经通路的调节。然而，缺乏确凿的证据，一些报告提出了相互矛盾的结果。目的：本综述的目的是评价针灸治疗偏头痛的有效性，并将其与标准药物治疗进行比较。检索策略：检索MEDLINE（通过PubMed）、Embase、Web of Science（所有数据库）、Cochrane和Epistemonikos数据库，检索2024年2月之前发表的英语、葡萄牙语、法语和西班牙语的文章，不受日期限制。纳入标准：纳入有或没有荟萃分析的随机对照试验的系统评价，比较针灸与标准药物治疗。根据国际指南，所有年龄诊断为发作性或慢性偏头痛的患者，无论有无先兆。主要结果是疼痛强度。次要结局包括每月偏头痛天数、缓解率、生活质量、辍学率、抢救药物的使用和不良事件。数据提取和分析：文章最初根据标题和摘要进行评估，后来根据全文进行评估，由两名独立审稿人进行评估。meta分析的数据来自于原始研究，采用随机效应模型。使用AMSTAR 2工具对纳入的综述的方法学质量进行评估，并对重叠程度进行评估。证据的确定性采用分级建议评估、发展和评价（GRADE）方法进行评估。结果：共纳入22篇综述，共纳入24,635例患者。大多数系统评价报告针灸组有更大的改善和更好的耐受性。meta分析显示，针灸治疗后疼痛强度有统计学意义的降低（标准均差[SMD]: -2.17； 95%可信区间[CI] [-3.25; -1.10]）； P结论：针灸治疗偏头痛是安全有效的替代药物治疗方法。当常规治疗无效时，当存在药物禁忌症时，或当首选非药物选择时，应将其视为一种预防性治疗。请在本文中注明：Pereira PA， Marto CM, Oliveiros B, Botelho MF。针灸是治疗偏头痛的有效替代药物：综述。集成医学[J]；打印前Epub。
{"title":"Acupuncture is an effective alternative to medication for migraine: An umbrella review.","authors":"Paulo Alexandre Pereira, Carlos Miguel Marto, Bárbara Oliveiros, Maria Filomena Botelho","doi":"10.1016/j.joim.2025.10.003","DOIUrl":"https://doi.org/10.1016/j.joim.2025.10.003","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a highly prevalent primary headache disorder that impacts individuals and societies around the globe. Acupuncture can be used in migraine treatment and prevention due to its analgesic effects, safety profile, and modulation of neural pathways. However, there is a lack of conclusive evidence, and some reports present conflicting results.</p><p><strong>Objective: </strong>The aim of this umbrella review is to evaluate the effectiveness of acupuncture in migraine treatment, comparing it to the standard pharmacological treatment.</p><p><strong>Search strategy: </strong>MEDLINE (via PubMed), Embase, Web of Science (all databases), Cochrane, and Epistemonikos databases were searched for articles published prior to February 2024 in English, Portuguese, French and Spanish, and no date restriction was applied.</p><p><strong>Inclusion criteria: </strong>Systematic reviews, with or without meta-analysis, of randomized controlled trials, comparing acupuncture with standard pharmacological treatment were included. Patients of all ages diagnosed with episodic or chronic migraine, with or without aura, according to international guidelines were included. The main outcome was the pain intensity. Secondary outcomes included days with migraine per month, response rate, quality of life, dropout rate, use of rescue medication, and adverse events.</p><p><strong>Data extraction and analysis: </strong>Articles were initially evaluated based on the title and abstract, and later based on the full text, independently by two reviewers. For the meta-analysis, data were extracted from the primary studies, and a random effects model was used. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool and the degree of overlap was also evaluated. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Twenty-two reviews encompassing 24,635 patients were included. Most systematic reviews reported greater improvements and better tolerability in the acupuncture group. The meta-analysis showed a statistically significant reduction in pain intensity (standard mean difference [SMD]: -2.17; 95% confidence interval [CI] [-3.25; -1.10]; P < 0.001) and in days with migraine per month (SMD: -2.92; 95% CI [-4.65; -1.20]; P < 0.001), both favoring acupuncture, but high heterogeneity among results was found. Subgroup analysis confirmed that this reduction persisted at 3 months after cessation of treatment. However, the outcome variables for response to treatment and occurrence of adverse events did not meet the threshold for statistical significance. The quality of included reviews was low to moderate, and the degree of overlap was considered moderate.</p><p><strong>Conclusion: </strong>Acupuncture is a safe and effective alternative to medication for migraine. It should be considered as a preventive treatmen","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688489","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 : 2025-09-18DOI: 10.1016/j.joim.2025.09.003
Ning Xu, Tao Huang, Long Wang
Astrocytes are the most abundant and morphologically intricate glial cells in the central nervous system, playing diverse and crucial roles in maintaining homeostasis within this system. Increasing evidence suggests that dysfunction of astrocytes contributes to the pathophysiology of depression. As an adjunctive and integrative therapy, acupuncture presents certain advantages in alleviating the severity of depressive symptoms. In comparison to conventional pharmacotherapy, acupuncture is distinguished by its relatively rapid onset of action, minimal side effects, and compatibility with concurrent pharmacological treatments. Preclinical studies indicate that acupuncture can ameliorate both morphological and functional impairments observed in the depressed brain by targeting neurons and glia. Specifically, research has demonstrated that acupuncture reduces morphological atrophy in astrocytes while also mitigating their dysfunction in rat models of depression. This therapeutic effect may be partially mediated through the regulation of enzyme expression, cytokines, neurotrophic factors, and intracellular signaling pathways within these glial cells. This review focuses on preclinical research investigating the mechanisms through which acupuncture may aid in treating depression, with an emphasis on astrocyte modulation. Please cite this article as: Xu N, Huang T, Wang L. Acupuncture in depression treatment: Insights into astrocyte regulation. J Integr Med. 2025; Epub ahead of print.
{"title":"Acupuncture in depression treatment: Insights into astrocyte regulation.","authors":"Ning Xu, Tao Huang, Long Wang","doi":"10.1016/j.joim.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.joim.2025.09.003","url":null,"abstract":"<p><p>Astrocytes are the most abundant and morphologically intricate glial cells in the central nervous system, playing diverse and crucial roles in maintaining homeostasis within this system. Increasing evidence suggests that dysfunction of astrocytes contributes to the pathophysiology of depression. As an adjunctive and integrative therapy, acupuncture presents certain advantages in alleviating the severity of depressive symptoms. In comparison to conventional pharmacotherapy, acupuncture is distinguished by its relatively rapid onset of action, minimal side effects, and compatibility with concurrent pharmacological treatments. Preclinical studies indicate that acupuncture can ameliorate both morphological and functional impairments observed in the depressed brain by targeting neurons and glia. Specifically, research has demonstrated that acupuncture reduces morphological atrophy in astrocytes while also mitigating their dysfunction in rat models of depression. This therapeutic effect may be partially mediated through the regulation of enzyme expression, cytokines, neurotrophic factors, and intracellular signaling pathways within these glial cells. This review focuses on preclinical research investigating the mechanisms through which acupuncture may aid in treating depression, with an emphasis on astrocyte modulation. Please cite this article as: Xu N, Huang T, Wang L. Acupuncture in depression treatment: Insights into astrocyte regulation. J Integr Med. 2025; Epub ahead of print.</p>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373331","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 : 2025-09-01DOI: 10.1016/j.joim.2025.05.002
Sheng-sheng Zhang , Lu-qing Zhao , Xiao-hua Hou , Zhao-xiang Bian , Jian-hua Zheng , Hai-he Tian , Guan-hu Yang , Won-sook Hong , Yu-ying He , Li Liu , Hong Shen , Yan-ping Li , Sheng Xie , Jin Shu , Bin-fang Zeng , Jun-xiang Li , Zhen Liu , Zheng-hua Xiao , Jing-dong Xiao , Pei-yong Zheng , Gui-jun Fei
Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations.
Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502–518.
{"title":"International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025)","authors":"Sheng-sheng Zhang , Lu-qing Zhao , Xiao-hua Hou , Zhao-xiang Bian , Jian-hua Zheng , Hai-he Tian , Guan-hu Yang , Won-sook Hong , Yu-ying He , Li Liu , Hong Shen , Yan-ping Li , Sheng Xie , Jin Shu , Bin-fang Zeng , Jun-xiang Li , Zhen Liu , Zheng-hua Xiao , Jing-dong Xiao , Pei-yong Zheng , Gui-jun Fei","doi":"10.1016/j.joim.2025.05.002","DOIUrl":"10.1016/j.joim.2025.05.002","url":null,"abstract":"<div><div>Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations.</div><div>Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). <em>J Integr Med</em>. 2025; 23(5):502–518.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"23 5","pages":"Pages 502-518"},"PeriodicalIF":4.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200572","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}
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