Perspectives on Integrative Medicine

Original Articles

Assessing the Impact of Art Therapy on Idiopathic Parkinson’s Disease: a Mixed-Methods Practice-Based Approach: Wangjung Hur, Jungtae Leem, Hanbit Jin, Miso S. Park, Sangsoo Park, Horyong Yoo; Perspect Integr Med. 2025;4(1):28-38. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.004; Funded: National Research Foundation of Korea

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Abstract PDF Supplementary Material: Background
Parkinson’s disease (PD) is a common degenerative brain condition worldwide. Art therapy has gained attention as a nonpharmacological, complementary, and integrative therapy, yet few studies have explored its effect on people with PD.
Methods
From May to August 2021, 9 participants diagnosed with idiopathic PD completed an art therapy program, consisting of 8 weekly sessions (60 minutes each). A mixed-method research approach combining quantitative and qualitative analyses was used to evaluate participant outcome and experience. Quantitative analysis was assessed using tests for quality of life, motor symptoms, and nonmotor symptoms. Qualitative analysis was conducted through participant responses and researcher observations.
Results
After 8 sessions of drawing-based art therapy, the total non-motor symptoms scale score, which provides a comprehensive assessment including the domains of cognition and behavior along with nonmotor symptoms in participants, significantly improved from 79.3 ± 30.9 at baseline to 59.8 ± 26.1 points after 8 weeks (p = 0.01). The unified Parkinson’s disease rating scale-I score also demonstrated significant improvement (p = 0.03). There were no reported adverse events and no participant dropout. Qualitative analysis revealed enhanced self-esteem, self-acceptance, and positive emotional expression amongst participants.
Conclusion
The art therapy conducted on the people with PD in this study improved their nonmotor symptoms and activity of daily living. Furthermore, qualitative analysis revealed the positive effect of art therapy which included improved self-esteem and self-acceptance. In the future, art therapy could be actively considered as a nonpharmacological, complementary, and integrative therapy for treating PD.

Effects of Needling Acupoint SI3 on Pressure Pain Threshold in Healthy Participants: Xiaoqin Wu, Chi Eung Danforn Lim, Shuai Zheng, Christopher Zaslawski; Perspect Integr Med. 2025;4(1):39-50. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.005; Funded: Australian Government Research Training Program Scholarship

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Abstract PDF: Background
There has been a surge in prescribing opioids for pain-related conditions and it has resulted in a prescription "opioid epidemic." It is critical for researchers and clinicians to explore nonpharmacological approaches to manage pain and mitigate the reliance on opioid analgesics. Acupuncture could be an effective therapy to modulate pain. This study examined the effects on regional pressure pain threshold (PPT) following needling of the Small Intestine 3 (SI3 -Houxi) acupoint in healthy participants.
Methods
In a randomized, three-arm cross-over design study, 32 healthy participants enrolled between November 2018 and March 2019, received 3 different acupuncture interventions, in different sequences, to the right hand at SI3: (1) SI3 without manual manipulation (SI3m-); (2) SI3 with manual needle manipulation (SI3m+); and (3) sham laser, to assess changes in PPT following the interventions. The mean change in PPT was measured at 10 different regional acupoint sites using an algometer. All PPT scores were reported as a percentage change from the mean preintervention value, the mean of the 3 PPT measurements obtained prior to receiving the intervention.
Results
The SI3m+ and SI3m- interventions for the 31 participants (drop out n=1), showed that the postintervention mean % PPT scores were significantly elevated compared to the control (sham laser; p < 0.001). The SI3m+ intervention significantly increased % PPT compared with the SI3m- intervention (p < 0.001).
Conclusion
The needling intervention was an important contributor raising regional PPT in healthy participants.

Protocol

Study Protocol for a Systematic Review of the Methods and Reliability of Sham Electroacupuncture in Randomized Controlled Trials: Sung Min Lim; Perspect Integr Med. 2025;4(1):62-64. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.008; Funded: Ministry of Health and Welfare, National Rehabilitation Center

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Abstract PDF: Background
Electroacupuncture (traditional acupuncture combined with electrical stimulation) is used to treat various medical conditions. However, the lack of standardized sham electroacupuncture options (placebo controls) poses a challenge in ensuring the validity of the results gained from randomized controlled trials (RCTs). This study presents a protocol for a systematic review to evaluate the methods and validity of sham electroacupuncture used in RCTs.
Methods
To provide evidence for establishing an optimal control model for sham electroacupuncture, a systematic review will be conducted by searching major English language electronic databases (including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) for studies published up to May 2024. RCTs that utilized sham electroacupuncture as a control group will be included. Two independent reviewers will screen the studies and extract the data, and the quality of the selected studies will be assessed using the Cochrane Risk of Bias Tool 2. Frequency analysis will be conducted, and to assess blinding in RCTs the Blinding Index will be reported. This systematic review protocol is registered with PROSPERO (no.: CRD42024542514).
Results
/Conclusion: This systematic review will provide a comprehensive analysis of the methods and reliability of sham electroacupuncture in RCTs and thus help identify current practices and gaps. The findings may contribute to the development of standardized sham electroacupuncture controls and improve the design RCT in the future which will facilitate treatment validation of electroacupuncture.

Review Articles

Effects of Acupuncture on Cartilage Degradation and Joint Pain in Osteoarthritis: Jae-Hwan Jang, Jaejin Han, Changsu Na, Hi-Joon Park; Perspect Integr Med. 2024;3(3):134-141. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.002; Funded: National Research Foundation of Korea, College of Korean Medicine, Kyung Hee University

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Graphical Abstract Abstract PDF: Osteoarthritis, resulting from joint decline, leads to various symptoms including joint pain, stiffness, tenderness, and local inflammation. These symptoms may be caused by the remodeling of the five structural phenotypes: inflammatory, subchondral bone, meniscal cartilage, atrophic, and hypertrophic phenotypes. Studies have shown that acupuncture can inhibit cartilage degradation by regulating extracellular matrix-degradation and enzyme synthesis. Notably, the efficacy of acupuncture treatment in osteoarthritis may be attributed to regulated inflammation and apoptosis of chondrocytes, as well as endogenous opioid production, and activation of the endocannabinoid systems (in the central and peripheral nervous systems), to contribute towards cartilage protection and joint pain relief. This review provides a current summary of the mechanisms of action of acupuncture in osteoarthritis, indicating that acupuncture, a therapy with fewer side effects than conventional medications, may be an effective treatment strategy for the management of osteoarthritis.

Trends in Clinical Research on Ultrasound-Guided Acupuncture: A Scoping Review: Sook-Hyun Lee, Yoon Jae Lee, Ju Yeon Kim, In Heo, Jae-Heung Cho, Byung-Kwan Seo, Yeoncheol Park, Jung-Hyun Kim, In-Hyuk Ha; Perspect Integr Med. 2024;3(3):152-161. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.004; Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare

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Graphical Abstract Abstract PDF Supplementary Material

Acupuncture is widely used to reduce pain and improve function in various conditions. Despite ongoing research in ultrasound-guided acupuncture, evidence supporting efficacy remains inconclusive. This study aimed to examine Korean and international research trends, clinical efficacy, and safety of ultrasound-guided acupuncture by performing a scoping review of clinical research on ultrasound-guided acupuncture. Literature searches were conducted across 11 databases, including all clinical studies published before April 2024, without restrictions on condition/disease or type of study. Of the 2,644 identified articles, 25 studies were selected for review, mostly involving patients with musculoskeletal pain, and post-stroke sequelae. Interventions included ultrasound-guided acupuncture, warming acupuncture, dry needling, and electroacupuncture. The effectiveness of ultrasound-guided acupuncture was evaluated using pain, functional disability, and effective rate as outcome measures, and most studies reported significant improvements. This study is the first scoping review to report on trends, clinical efficacy, and safety of ultrasound-guided acupuncture. While it demonstrates potential for treating musculoskeletal disorders, post-stroke sequelae, spinal injuries, and other conditions/diseases, research on its application remains limited to specific conditions/diseases. Furthermore, substantial variations were observed in types of acupuncture, application areas, and treatment frequencies. Future research should focus on high-quality randomized controlled trials with standardized ultrasound frequencies for specific conditions/diseases.

Citations

Citations to this article as recorded by

Efficacy of ultrasound-guided pharmacopuncture: A systematic review and meta-analysis
Jinho Lee, Sook-Hyun Lee, Yoon Jae Lee, Ju Yeon Kim, In Heo, Jae-Heung Cho, Byung-Kwan Seo, Dong Kun Ko, In-Hyuk Ha
Medicine.2025; 104(11): e41733. CrossRef

Protocol

A Protocol for the Validation of Novel Sham Acupuncture in Patients Who Have Had a Stroke: Sung Min Lim; Perspect Integr Med. 2024;3(3):168-171. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.006; Funded: National Research Foundation of Korea

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Graphical Abstract Abstract PDF Supplementary Material: Background
A sham control group enhances the quality of clinical trials by controlling for the placebo effect. To ensure rigorous blinding to enhance the quality of clinical trials on acupuncture treatment it is important to develop a more sophisticated sham needle. Discrepancies in perceived needling sensation and treatment expectations between patients and healthy volunteers may affect study outcomes. Thus, it may be inappropriate to generalize the findings of a sham needle validation study in healthy adults to patients who have had a stroke. Therefore, this is a protocol for a clinical trial in patients who have had a stroke to validate a newly developed sham needle to be used in double-blind trials.
Methods
Sixty-six patients who have had a stroke will be randomly assigned to the verum or sham needle group using a 1:1 ratio. As the verum and sham needles are identical in appearance, both participants and practitioners will be unaware of the needle type used for acupuncture treatment. After the acupuncture procedure, the participants will be asked whether they believe they received the verum or sham acupuncture treatment and indicate penetration, pain, and de qi sensation for each acupuncture point. A between-group comparison of needle-related adverse events will be performed.
Discussion
This double-blind randomized controlled trial will be the first study to validate a newly developed sham acupuncture needle for patients who have had a stroke. The results of this study may inform clinical trial study design for acupuncture treatment of patients who have had a stroke.

Editorials

Reporting Overviews of Reviews: PRIORitizing a Reporting Guideline: Lisa Hartling, David Moher; Perspect Integr Med. 2024;3(2):65-68. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.001; Funded: Canada Research Chairs

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Graphical Abstract PDF

Korean Medicine Innovative Technologies Development Project: Integrative Advances and Comprehensive Overview of the National R&D Initiative: Yoon Jae Lee, Seungwon Shin, Junhyeok Yi, Minjung Park; Perspect Integr Med. 2024;3(2):69-73. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.002; Funded: Ministry of Health and Welfare

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Citations

Citations to this article as recorded by

Integrative personalized medicine care for adjustment disorder of a post-COVID-19 patient: A CARE-compliant case report
Won-Kyoung Moon, Ja-Yeon Jeong, Sang-Woo Park, Su-Yeon Yun, Euiju Lee, Seungwon Shin
Medicine.2024; 103(31): e39121. CrossRef
Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
Perspectives on Integrative Medicine.2024; 3(3): 162. CrossRef
Bee Venom Acupuncture for Shoulder Pain: A Literature Review of Clinical Studies
Hyein Jeong, Soobin Jang, Jang-Kyung Park, Kyeong Han Kim, Jong Hyun Park, Gihyun Lee, Soo-Hyun Sung
Toxins.2024; 16(11): 501. CrossRef

Review Articles

Current Status and Challenges of the Evidence for Cupping Therapy in Clinical Practice Guidelines in Korea: Seungwon Shin; Perspect Integr Med. 2024;3(2):74-85. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.003; Funded: Sangji University

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Graphical Abstract Abstract PDF Supplementary Material

Clinical practice guidelines (CPGs) published in Korea were reviewed to evaluate up-to-date evidence and the recommendations for cupping therapy (CT) to inform clinicians and researchers for future studies. There were 14 CPGs (allergic rhinitis, ankle sprain, cervical pain, chronic low back pain, cold hands and feet, facial nerve palsy, Hwabyung, knee osteoarthritis, lumbar herniated intervertebral disk, migraine, osteoporosis, postoperative syndrome, shoulder pain, and traffic accident injury) with 29 recommendations for CT determined from “low” to “moderate” rated evidence. The levels of evidence were mostly downgraded due to the risk of bias and imprecision. The majority of recommendations for CT were graded as B or C. This comprehensive analysis underscores the imperative need for robust clinical research, including randomized controlled trials and observational studies using real-world data to enhance the quality of the evidence for CT. In addition, recommendations providing definite phases or scope of the target conditions/diseases and treatment regimens should be employed. This work lays a foundational step towards integrating CT into evidence-based clinical practice, emphasizing strategic directions for future research to bridge the gap between evidence and practice.

Citations

Citations to this article as recorded by

Bee Venom Acupuncture in Traditional Korean Medicine: A Review of Clinical Practice Guidelines
Minjung Park, Seungwon Shin
Toxins.2025; 17(4): 158. CrossRef

Addressing the Challenges of Traditional, Complementary, and Integrative Medicine Research: An International Perspective and Proposed Strategies Moving Forward: Maheen Raja, Holger Cramer, Myeong Soo Lee, L. Susan Wieland, Jeremy Y. Ng; Perspect Integr Med. 2024;3(2):86-97. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.004; Funded: National Institutes of Health, National Center for Complementary and Integrative Health

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5 Citations

Graphical Abstract Abstract PDF

Traditional, complementary, and integrative medicine (TCIM) encompasses a broad range of healthcare practices beyond conventional Western medicine. Despite its use globally and increased research, many TCIM research challenges persist impeding its progress and integration into clinical practice. Key challenges involve financial constraints, insufficient research training and educational support, and the methodological barriers which arise from a lack of standardization. Financial limitations hinder investment into crucial research limiting both the quantity and quality of TCIM research. Inadequate training in research and educational support limit the development of TCIM research, hindering growth and recognition of TCIM in academic and clinical settings. The inherent dynamic nature of TCIM therapies poses additional challenges for applying standardized biomedical research models. These challenges not only impede the advancement of TCIM research but also perpetuate negative attitudes and biases within the healthcare and research communities. To overcome these challenges, a comprehensive strategy is necessary to increase funding, improve literacy, and the promotion of open science practices in TCIM. Addressing these confounding factors will enable well-informed TCIM research literacy and the development of TCIM skills and facilitate the integration of evidence based TCIM therapies into a more inclusive healthcare domain, ultimately reducing negative attitudes and biases towards TCIM.

Citations

Citations to this article as recorded by

“There is a way to work together”: A qualitative study on complementary medicine therapists' perceptions of their role in the Swiss healthcare system
Julie Dubois, Pierre-Yves Rodondi, Christina Akre
Complementary Therapies in Clinical Practice.2025; 58: 101919. CrossRef
The case for data sharing in traditional, complementary, and integrative medicine research
Jeremy Y. Ng
Integrative Medicine Research.2025; 14(1): 101101. CrossRef
A Protocol for a Bibliometric Analysis of Traditional, Complementary, and Integrative Medicine Research Preprints
Jeremy Y. Ng, Brenda Lin, Sabrina Abdella, Magdalene Abebe, Isabella Tao, Holger Cramer
Perspectives on Integrative Medicine.2024; 3(3): 172. CrossRef
Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
Perspectives on Integrative Medicine.2024; 3(3): 162. CrossRef
PRIO – a prospective integrative oncology registry: trial protocol
Paul G. Werthmann, Ann-Kathrin Lederer, Hannah Maja Figura, Klaus Kramer
Frontiers in Oncology.2024;[Epub] CrossRef

Original Articles

The Status of Nationwide Implementation of Integrative Medicine Programs by Japanese Local Government from a “Social Model” Viewpoint: Hui-Yu Chung, Masaki Moroi, Yasutaka Hojo, Fu-Shih Chen, Keiko Yukawa, Yoshiharu Motoo, Ichiro Arai; Perspect Integr Med. 2024;3(2):98-105. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.005; Funded: Japan Agency for Medical Research and Development

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Graphical Abstract Abstract PDF

Background
The world's demographics are transitioning, prompting governments globally to adopt diverse health promotion and disease prevention programs to enhance people's quality of life. While several integrative medicine (IM) programs, including traditional or alternative medicine, may be in place, the level of implementation nationwide is unknown. This research represents the first nationwide study in Japan, conducted in 2018 before local government health programs were cancelled due to the COVID-19 pandemic. The study examines the use of IM by local government in Japan and its safety and effectiveness as a “social model.”
Methods
IM programs for disease prevention and health promotion of all 1,944 Japanese local governments in 2018, were retrieved the using the Web Archive Project of the National Diet Library, which is a maintained website repository for all Japanese local government including IM and health programs.
Results
A total of 1,739 IM programs were implemented in 537 local governments (27.6% among all Japanese local governments). These included programs for Yoga (1,242; 71.4% of the projects), Qigong (211; 12.1%), and Aromatherapy (145; 8.3%). Among the providers of the programs, only 16 (0.9%) were national medical-related license holders. The purpose of disease prevention or health promotion was not described with scientific basis (safety and effectiveness).
Conclusion
Japanese local government conduct health-promoting IM programs, but untrained providers administer many of them. There needs to be more evidence to support the alleged health promotion objectives. Local governments require better support and evidence-based planning to rectify this situation.

Citations

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Advanced Glycation End-Product-Modified Heat Shock Protein 90 May Be Associated with Urinary Stones
Takanobu Takata, Shinya Inoue, Kenshiro Kunii, Togen Masauji, Junji Moriya, Yoshiharu Motoo, Katsuhito Miyazawa
Diseases.2025; 13(1): 7. CrossRef

Shilajit, a Natural Phytocomplex Acts as a Neuroprotective Agent Against Amyloid Beta-induced Cytotoxicity and Inflammation: Seoyoung Kim, Changon Seo, HyeJin Park, Jin Gwan Kwon, Jin Kyu Kim, Hyoun Jong Moon, Sunki Lim, Yujeong Gho, Wang Jun Lee, Yongmun Choi, Sanghun Lee; Perspect Integr Med. 2024;3(2):114-122. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.007; Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare

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Abstract PDF Supplementary Material: Background
Shilajit is a natural phytocomplex known for centuries in Ayurveda traditional medicine for its antioxidant, immunomodulatory, and neuroprotective properties. However, there is little published scientific evidence to support these acclaimed properties.
Methods
The safety, regarding the heavy metal content, component analysis, the neuroprotective effects and amyloid beta (Aβ)-induced cytotoxicity and inflammation of 3 samples of Shilajit derived from different geographical origins were assessed. Neuroprotective effects of Shilajit were examined using neuroblastoma cell lines (SH-SY5Y and IMR-32) and cell viability assays. The inhibitory effect on the proinflammatory cytokine derived from macrophage cells was assessed using bone marrow-derived macrophage cells in vitro and in a murine model of Aβ-induced inflammation (ex vivo analysis).
Results
The results showed that a daily dose of each Shilajit sample were within the permissible heavy metal limit established by the United States Food and Drug Administration. The 3 Shilajit samples alleviated Aβ-induced toxicity in neuronal cells. One sample derived from the Altai Mountains suppressed Aβ-induced processing of pro-interleukin (pro-IL)-1β into mature, biologically active IL-1β in macrophages. This Shilajit sample inhibited Aβ-induced production of the proinflammatory cytokine IL-1β in the brain (ex vivo analysis). In component analysis, this sample was enriched in salicyluric acid.
Conclusion
Shared and distinct properties were observed among the 3 Shilajit samples concerning their neuroprotective effects, and regarding safety, the daily dose of each Shilajit had a safe level of heavy metal content. Salicyluric acid in Shilajit may be important in mitigating Aβ-induced inflammatory cytokine but more research is necessary.

Protocol

Protocol for a Scoping Review of Traditional and Complementary Medicine Governance Across Sub-Saharan Africa: Tendayi R. Chihaka, Nadine Ijaz, Ossy M.J. Kasilo, Peter B. James, Daniel F. Gallego Pérez, Jon Wardle, Razak M. Gyasi; Perspect Integr Med. 2024;3(2):123-128. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.008; Funded: Carleton University

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Abstract PDF Supplementary Material: Background
Since 1978, the World Health Organization (WHO) has repeatedly called on Member States to recognize the role of traditional and complementary medicine (T&CM) in primary healthcare, improve safety, and accessibility by governing T&CM. In the 2019 Global Report on T&CM, the WHO reported that 40 out of 47 (85%) Member States from African Region had enacted governance policies, and 20 out of 47 (43%) had regulatory policies on herbal medicines. The primary barriers to implementing T&CM policy were identified as an absence of data and inadequate financial support for research. The objective of this protocol was to detail how to perform a scoping review that will examine the policy, legislative, and regulatory landscape for T&CM practitioners and products in sub-Saharan Africa.
Methods
Databases will be searched (AMED, CINAHL Plus with Full Text, MEDLINE Plus with Full text, Web of Science, Scopus, PubMed, Google Scholar) for relevant articles. Searches will be limited to English, French, Portuguese, and Spanish language studies in peer-reviewed journals (1963-2023) that substantively report on legislation, bills, policies, governance approaches and regulations on T&CM (including successes and/or challenges in their design and implementation). Actual legislation, policies, and regulatory documents on T&CM and peer-reviewed studies with emphasis on integrating T&CM and biomedicine into healthcare systems will be excluded.
Expected Outcomes
This protocol has formulated the objectives for a scoping review to identify, map, and synthesize evidence on the governance of T&CM in sub-Saharan Africa.

Editorial

A Pilot Trial of Integrative Medicine for Stroke Rehabilitation: Expert Recommendations for the Development and Sustainability of Integrative Medicine: Chihyoung Son, Go-Eun Lee, Joo-Hee Seo, Inae Youn, Jin-Won Kim; Perspect Integr Med. 2024;3(1):1-6. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.001; Funded: Ministry of Health and Welfare

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Graphical Abstract Abstract PDF: Background
Strategies towards development and sustainability of integrative treatment in stroke rehabilitation medicine are needed. National expert recommendations based on the implementation of Integrative Medicine (IM) in stroke rehabilitation and IM outcomes would be invaluable.
Methods
A pilot study was performed and the effectiveness of combining Korean traditional medicine and Western conventional medicine in post-stroke patients (ischemic stroke n = 15 and hemorrhagic stroke n = 4) was evaluated, and recommendations were developed through consensus with physicians in national centers of rehabilitative medicine. Outcome measures [Korean Modified Barthel Index (K-MBI), Korean Mini Mental State Examination (K-MMSE), Modified Rankin Scale (mRS), and EuroQol 5-dimension 5-level (EQ-5D-5L) assessment were used at baseline, 4, 8 (K-MBI, K-MMSE, mRS, and EQ-5D-5L) and 12 weeks post treatment (EQ-5D-5L and mRS).
Results
Improvements were observed in functional and cognitive abilities at 8 weeks (K-MBI score p = 0.0062; K-MMSE score p = 0.046). Quality of life improvements (EQ-5D-5L) were observed but were not statistically significant. The disability assessment (mRS) indicated a gradual improvement from baseline to 12 weeks. No adverse events were reported. For effective, patient-centered IM treatment: (1) build a strong evidence base for IM as compared with Western medicine alone or traditional medicine alone; (2) active expert collaboration; (3) IM promotion in public medical institutions; and (4) continued government support.
Conclusion
Functional and cognitive abilities of stroke patients statistically significantly improved following 8 weeks of IM treatment. Strategies have been suggested towards the development and sustainability of IM treatment in stroke rehabilitation medicine.

Review Article

Characteristics and Quality of Traditional Chinese Therapies and Integrative Medicine Clinical Practice Guidelines for Musculoskeletal Disorders Published in Mainland China: Xue-Feng Wang, Jing-Ling Zuo, Lin-Jian Li, Lan-Dan Xu, Xiao-Zhong Liu, Si-Si Ma, Jian-Ping Liu; Perspect Integr Med. 2024;3(1):7-17. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.002; Funded: National Natural Science Foundation of China

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Graphical Abstract Abstract PDF Supplementary Material

Background
Musculoskeletal disorders are prevalent in adults. Traditional Chinese medicine (TCM) and integrative medicine (IM) are commonly used treatments which have clinical practice guidelines (CPGs). This study aimed to determine the characteristics and quality of these CPGs.
Methods
CPGs which recommended TCM/IM therapies in musculoskeletal conditions/diseases published in Chinese or English between January 2018 to December 2022 in mainland China were retrieved and analyzed for guideline classification, funding source, conflict of interest, and methodology. Appraisal of Guideline for Research and Evaluation Ⅱ including 6 domains, was applied to assess CPG quality.
Results
Of the 50 CPGs included, there were 19 TCM, 5 IM, and 26 western conventional medicine (WCM) guidelines of which osteoporosis (13, 26%), osteoarthritis (11, 22%) and rheumatoid arthritis (6, 12%) were the most frequent diseases. The TCM therapies recommended by the CPGs successively were acupuncture and moxibustion, Chinese patent medicine, and TCM decoction based on syndrome differentiation. Nearly half of the CPGs reported funding source (52%) and conflict of interest (48%). Thirty-six CPGs used the Grading of Recommendations, Assessment, Development, and Evaluations method to present summaries of evidence, the remaining did not report the method. Based on Appraisal of Guideline for Research and Evaluation Ⅱ scores, “clarity of presentation” scored the highest (55%), while “applicability” was the lowest (6%). No CPG was recommended without change, and 23 CPGs were not recommended.
Conclusion
The quality of CPGs for musculoskeletal conditions/diseases in China is generally low. Future CPGs should pay more attention to standardized developing procedures.

Citations

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Combination therapy of shinbaro and celecoxib improves joint pain and cartilage degradation in an osteoarthritis mouse model
Jae-Hwan Jang, Yurim Song, Seok Hee Han, Bo Ram Choi, Yoon Jae Lee, In-Hyuk Ha
Journal of Traditional and Complementary Medicine.2025;[Epub] CrossRef
Effects of Combined Shinbaro and Celecoxib in a Complete Freund’s Adjuvant-Induced Inflammatory Pain Mouse Model
Jae-Hwan Jang, Yurim Song, Seok Hee Han, Bo Ram Choi, Yoon Jae Lee, In-Hyuk Ha
Journal of Inflammation Research.2025; Volume 18: 2349. CrossRef

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