Perspectives on Integrative Medicine

Most viewed articles are from the articles published in 2023 during the last three month.

Review Article

The Role of Animal Assisted Therapy in the Rehabilitation of Mental Health Disorders: A Systematic Literature Review: Denis Arsovski; Perspect Integr Med. 2024;3(3):142-151. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.003

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Graphical Abstract Abstract PDF: Mental health disorders like depression, anxiety, post-traumatic stress disorder (PTSD), and schizophrenia significantly reduce the daily functioning and quality of life of individuals. Traditional treatments often fall short, thus opening interest in complementary therapies like animal assisted therapy (AAT) which encourages the human-animal bond and gives emotional and psychological support. This review evaluated the efficacy of AAT in treating mental health disorders, and understanding its mechanisms and benefits. A comprehensive literature review was conducted (using databases such as PubMed, Google Scholar, and ResearchGate) focused on peer-reviewed articles, systematic reviews and meta-analyses published in the last 2 decades. Studies indicated that AAT improved mental health outcomes for people with depression, anxiety, PTSD, and schizophrenia. Interaction with therapy animals reduced cortisol levels, increased oxytocin, lowered blood pressure, and increased social engagement and emotional regulation. Benefits included reduced symptoms of depression, anxiety, PTSD, and improved social functioning and quality of life. AAT offered a complementary treatment for mental health disorders, providing emotional comfort, improving mood, and serving as a nonpharmacological option for individuals. However, challenges such as individual preferences, allergies, ethical concerns for therapy animals, and logistical issues must be addressed. Future research should focus on the long-term effects and mechanisms involved to optimize the application of AAT in the clinical setting, and alternatives like robotic companion pets could also be explored.

Original Article

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

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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.

Review Articles

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

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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

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“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

Effectiveness and Safety of Low-Level Laser Treatment for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis: Sang Jun Lee, Seung Jin Noh, Jeong Rock Kim, Kyung Bok Park, Sae-rom Jeon, Yejin Hong, Dongwoo Nam; Perspect Integr Med. 2023;2(3):155-163. Published online October 23, 2023; DOI: https://doi.org/10.56986/pim.2023.10.003

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Graphical Abstract Abstract PDF Supplementary Material: Background
Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.
Methods
Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.
Results
The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): -1.90, 95% confidence interval (CI): -2.01, -1.80, I2 80%; LBP VAS MD: -0.79, 95% CI: -0.87, -0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: -2.52, 95% CI: -2.65, -2.40, I2 97%; LBP VAS MD: -1.47, 95% CI: -1.58, -1.36; Oswestry Disability Index MD: -4.10, 95% CI: -4.55, -3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”
Conclusion
LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.

Editorial

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

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Graphical Abstract PDF

Citations

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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

Clinical Research on Pharmacopuncture in Korea: A Scoping Review: Me-riong Kim, Seong Min Lee, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2023;2(1):8-23. Published online February 21, 2023; DOI: https://doi.org/10.56986/pim.2023.02.003

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16 Citations

Graphical Abstract Abstract PDF Supplementary Material

This scoping review was performed as an update on the effects and safety of pharmacopuncture clinical research for the treatment of multiple indications in Korea. Nine electronic databases were searched to identify comparative clinical studies and clinical practice guidelines on Korean pharmacopuncture from inception to December 31, 2022. In vivo and in vitro studies, and case reports were excluded. There were 226 studies identified, including randomized controlled trials, retrospective comparison observational studies, and single-subject crossover designs, of which 17 focused on clinical safety profiles. Most studies pertained to rehabilitation medicine, especially for musculoskeletal (n = 129) and nervous system disorders (n = 35). The evidence supported treatment of neoplasms, obesity, and stroke sequelae. Adverse events of pharmacopuncture were mostly mild and temporary, and occurred more frequently with bee venom compared with herb-derived solutions. Thirty-five clinical practice guidelines including recommendations on pharmacopuncture were included. To the best of our knowledge, this is the first scoping review of clinical pharmacopuncture use in Korea, and our findings support its use in clinical practice and research. Considering the diverse clinical applications of pharmacopuncture, additional pragmatic trials are required to further strengthen the evidence base and develop standard research methodology in Korean medicine.

Citations

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Cost‐Effectiveness of Hominis Placenta Therapy for Chronic Temporomandibular Disorder: An Economic Evaluation Alongside a Pragmatic Randomised Controlled Trial
Doori Kim, Eun‐San Kim, Koh‐Woon Kim, Jae‐Heung Cho, Yoon Jae Lee, In‐Hyuk Ha
Journal of Oral Rehabilitation.2025;[Epub] CrossRef
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
The effect of integrative Korean medicine treatment on symptomatic lumbar facet joint cysts: A case series
Hee-seung Choi, Yoon Jae Lee, Dae-Hyun Hahm, Hyangsook Lee, In-Hyuk Ha
EXPLORE.2024; 20(1): 130. CrossRef
Long-Term Follow-Up of Inpatients with Rotator Cuff Tear Who Received Integrative Korean Medicine Treatment: A Retrospective Analysis and Questionnaire Survey
Dong-Hwi Yoo, Jae-Yong Choi, Sang-Gun Lee, Ki-Won Choi, Han-Bin Park, Ho Kim, Hyunwoo Cho, Sang Don Kim, Doori Kim, Yoon Jae Lee, Kyoung Sun Park, In-Hyuk Ha
EXPLORE.2024; 20(2): 212. CrossRef
Long-term follow-up of inpatients with meniscus tears who received integrative Korean medicine treatment: A retrospective analysis and follow-up survey
June Haeng Lee, Jin Young Song, Kyoung Sun Park, Jinho Lee, In-Hyuk Ha, Yoon Jae Lee
Medicine.2024; 103(6): e36917. CrossRef
Pharmacopuncture therapy for adhesive capsulitis: A pragmatic randomized controlled pilot study
Doori Kim, Kyoung Sun Park, Sun-A Kim, Ji Yeon Seo, Hyun-Woo Cho, Yoon Jae Lee, Changsop Yang, In-Hyuk Ha, Chang-Hyun Han
Integrative Medicine Research.2024; 13(3): 101065. CrossRef
Effectiveness of lumbar motion style acupuncture treatment on inpatients with acute low back pain: A pragmatic, randomized controlled trial
Oh-Bin Kwon, Dong Wook Hwang, Dong-Hyeob Kang, Sang-Joon Yoo, Do-Hoon Lee, Minjin Kwon, Seon-Woo Jang, Hyun-Woo Cho, Sang Don Kim, Kyong Sun Park, Eun-San Kim, Yoon Jae Lee, Doori Kim, In-Hyuk Ha
Complementary Therapies in Medicine.2024; 82: 103035. CrossRef
Survey on the current usage of ultrasound-guided procedures in Korean Medicine Clinics and Hospitals
Ju Yeon Kim, Jung Min Yun, Sook-Hyun Lee, Yoon Jae Lee, Dong Kun Ko, In Heo, Woo-Chul Shin, Jae-Heung Cho, Byung-Kwan Seo, In-Hyuk Ha
Medicine.2024; 103(14): e37659. CrossRef
Effectiveness and safety of hominis placental pharmacopuncture for chronic temporomandibular disorder: A multi-center randomized controlled trial
Kyoung Sun Park, Eun-San Kim, Koh-Woon Kim, Jae-Heung Cho, Yoon Jae Lee, Jinho Lee, In-Hyuk Ha
Integrative Medicine Research.2024; 13(2): 101044. CrossRef
Analysis of Research Trends on the Korean Medicine Treatments of Subacromial-Subdeltoid Bursitis
Hyunsuk Park, Dong-Jin Jang, Jonghyun Lee, Sungjae Yoo, Minji Sun, Junsoo Kim, Yongjun Kim, Jeong-Hee Noh, Si-Hyoung Kim, Jung-Min Yun
Journal of Korean Medicine Rehabilitation.2024; 34(2): 85. CrossRef
Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial
Ja-Yean Son, Kangmoo Goo, Na-young Kim, Seok-Gyu Yang, Dong Hwan Lee, Yu-Ra Im, Oh Bin Kwon, Hyun-Woo Cho, Sang Don Kim, Doori Kim, In-Hyuk Ha
Journal of Clinical Medicine.2024; 13(15): 4457. CrossRef
Integrative Korean medicine treatment for inpatients with osteoarthritis of the knee: An observational study
Soo Kyeong Lee, Eun Je Oh, Gun Hee Bae, Jae Hyuk Woo, Yoon Jae Lee, In-Hyuk Ha, Ju Yeon Kim, Doori Kim
Medicine.2024; 103(32): e39183. CrossRef
Integrative Medicine Focusing on Ultrasound-Guided High-Dose Shinbaro 2 Pharmacopuncture for Acute Herniated Intervertebral Discs: A Case Report
Nam-Woo Lee, Jinho Lee, Jung-Min Yun, Siwon Kim, Won-Seok Chung
Healthcare.2024; 12(16): 1620. CrossRef
Common Peroneal Nerve Entrapment Masked by Acute Lumbar Disc Herniation: Integrated Korean Medicine Treatment with Ultrasound-Guided Pharmacopuncture
Hyunsuk Park, Jinhyun Kim, Sungjae Yoo, Jung-Min Yun, Kwangchan Song
Perspectives on Integrative Medicine.2024; 3(3): 177. CrossRef
A Pragmatic Randomized Controlled Trial on the Effectiveness and Safety of Pharmacopuncture for Chronic Lower Back Pain
Kyoung Sun Park, Changnyun Kim, Joo Won Kim, Sang‐Don Kim, Jee Young Lee, Yoon Jae Lee, Jinho Lee, Min Ji Kim, Young Eun Choi, Changsop Yang, Chang-Hyun Han, In-Hyuk Ha
Journal of Pain Research.2023; Volume 16: 2697. CrossRef
Domestic Clinical Research Trends of Shinbaro Pharmacopuncture: Scoping Review
Yeongmin Kim, Yunhee Han, Seungkwan Choi, Jungho Jo, Byeonghyeon Jeon, Hyeonjun Woo, Wonbae Ha, Junghan Lee
Journal of Korean Medicine Rehabilitation.2023; 33(4): 125. CrossRef

An Umbrella Review of Systematic Reviews for Chuna (or Tuina) Manual Therapy on Musculoskeletal Disorders: Doori Kim, Gil Geun Baek, Byung-Cheul Shin; Perspect Integr Med. 2023;2(3):142-154. Published online October 23, 2023; DOI: https://doi.org/10.56986/pim.2023.10.002

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Graphical Abstract Abstract PDF Supplementary Material

Background
To provide clinicians with reliable evidence an umbrella review of systematic reviews (SRs) on Chuna manual therapy (CMT) for musculoskeletal disorders was performed to synthesize important outcomes.
Methods
There were eight databases (Cochrane, EMBASE, MEDLINE, CNKI, KMBASE, KISS, Scienceon, and OASIS) searched as well as the international database Prospective Register of Systematic Reviews in health and social care until August 2023. SRs of randomized controlled trials involving patients with musculoskeletal conditions, limited to interventions explicitly labeled as “Chuna” or “Tuina” in English, Chinese, or Korean language were retrieved. Two reviewers independently conducted selection and data extraction, and SR quality was assessed using A Measurement Tool to Assess Systematic Reviews tool (low, medium, or high quality).
Results
This review included 32 SRs, categorized by cervical (n = 4), thoracolumbar (n = 7), upper extremity (n = 5), lower extremity (n = 9), and other musculoskeletal disorders (n = 7). Quality assessments determined that three SRs were of “high” quality, two were “low” quality, and the remaining SRs were of “medium” quality. CMT was consistently reported to demonstrate superior outcomes: an effective rate was observed in 17 of 19 SRs, CMT was effective at reducing pain in 12 of the 16 SRs, and functional outcomes of CMT were observed in 8 of 12 SRs. No serious adverse events were reported.
Conclusion
CMT may be a safe and effective treatment for various musculoskeletal disorders based on the limited number of studies and the low quality of included SRs.

Citations

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Integrative Korean medicine for recurrent lumbar disc herniation after coronavirus disease vaccination: A case report and literature review
Ah-Ra Koh, Hyun-Woo Kim, Young-Jin Lee, Hye-Jeong Jo, Go-Eun Chae, Dong-Woo Kim, In-Hyuk Ha, Doori Kim
Medicine.2025; 104(1): e41079. CrossRef
Comparative Effectiveness of Non-Pharmacological and Pharmacological Treatments for Non-Acute Lumbar Disc Herniation: A Multicenter, Pragmatic, Randomized Controlled, Parallel-Grouped Pilot Study
Doori Kim, Jee Young Lee, Yoon Jae Lee, Chang Sop Yang, Chang-Hyun Han, In-Hyuk Ha
Journal of Clinical Medicine.2025; 14(4): 1204. CrossRef
Integrative Korean medicine treatment without surgery for the management of subacute radiating pain attributed to vertebral artery loop formation: A case report and literature review
Jung Min Yun, Dong Hyun Go, Sook-Hyun Lee
Medicine.2025; 104(9): e39483. CrossRef
Reporting Overviews of Reviews: PRIORitizing a Reporting Guideline
Lisa Hartling, David Moher
Perspectives on Integrative Medicine.2024; 3(2): 65. CrossRef
Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial
Ja-Yean Son, Kangmoo Goo, Na-young Kim, Seok-Gyu Yang, Dong Hwan Lee, Yu-Ra Im, Oh Bin Kwon, Hyun-Woo Cho, Sang Don Kim, Doori Kim, In-Hyuk Ha
Journal of Clinical Medicine.2024; 13(15): 4457. CrossRef

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

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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.

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

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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.

Original Articles

Acupuncture Needles and the Risk of Lymphedema After Breast Cancer Surgery: A Retrospective National Cohort Study: Ye-Seul Lee, Yucheol Lim, Jiyoon Yeo; Perspect Integr Med. 2024;3(1):29-36. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.004

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Graphical Abstract Abstract PDF Supplementary Material: Background
Controversies remain over the impact of using needles on breast cancer patients after surgery due to risk of breast cancer-related lymphedema (BCRL). While recent literature suggests that vascular access during the postsurgical stage does not affect the risk of BCRL, the impact of acupuncture on the risk of BCRL during the postsurgical stage has not been studied.
Methods
This study included 35,153 patients from 2011 to 2013 who were newly diagnosed with breast cancer in a population-based cohort from the Korean National Health Insurance Service database. All patients received breast surgery, and the treatment group received acupuncture for more than 3 sessions in the 3-6 months post-surgery. The control group did not receive acupuncture. The incidence rate ratio, Kaplan-Meier curve, and Cox proportional hazards models were used to compare the risk of BCRL, and death between groups.
Results
About 5.8% of the study population received acupuncture during the 3-6 months post-surgery treatment window. After propensity score matching, the acupuncture treatment group did not show an increased risk of BCRL (IRR 1.017, 95% CI 0.868-1.193; unadjusted HR 1.018, 95% CI 0.868-1.193). This risk was robust in all multivariate Cox proportional hazards models.
Conclusion
An association of BCRL with acupuncture was not observed. Patients who received acupuncture to manage symptoms such as pain during the 3-6 months postsurgical stage did not have a higher risk of developing BCRL. Breast cancer patients who seek acupuncture to alleviate post-surgery symptoms such as pain, can receive acupuncture without concerns for potential risk of BCRL.

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

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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.

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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

Case Report

Common Peroneal Nerve Entrapment Masked by Acute Lumbar Disc Herniation: Integrated Korean Medicine Treatment with Ultrasound-Guided Pharmacopuncture: Hyunsuk Park, Jinhyun Kim, Sungjae Yoo, Jung-Min Yun, Kwangchan Song; Perspect Integr Med. 2024;3(3):177-183. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.008

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Abstract PDF

The symptoms of common peroneal nerve (CPN) entrapment are similar to the symptoms of lumbar herniated intervertebral disc. We present the successful treatment of CPN entrapment masked by acute lumbar disc herniation. A 49-year-old man presented with low back pain and numbness in his left leg. Following admission, patient history, physical examination, and radiology findings, the patient received integrated Korean medicine (KM) treatment (acupuncture, pharmacopuncture, ultrasound-guided pharmacopuncture, moxibustion and cupping, herbal medicine, and chuna therapy) for lumbar disc herniation. Outcome measures included the numeric rating scale, the European quality of life five dimensions, and the Oswestry disability index. Symptoms persisted, and CPN compression was consequently suspected. On Day 12 of 23, in addition to KM treatment, an ultrasound-guided Shinbaro2 pharmacopuncture (4 mL) was performed on the CPN entrapment site. Significant symptom relief resulted after CPN treatment on Day 12. Improvement was particularly evident in the lower leg and ankle, areas where the pain had previously been misattributed to symptoms of lumbar disc herniation. His low back pain and radiating pain to the back of the left femur started to improve from Day 20 and were mild at discharge. This case highlights the importance of considering peripheral nerve entrapment in patients presenting with symptoms similar to lumbar disc herniation. It also suggests that combining traditional KM with modern diagnostic techniques such as ultrasonography, may be beneficial in the precise location for pharmacopuncture treatment. Further studies are recommended to validate these findings and explore the broader applicability of this approach.

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Differential Gene Expression Analysis in a Lumbar Spinal Stenosis Rat Model via RNA Sequencing: Identification of Key Molecular Pathways and Therapeutic Insights
Jin Young Hong, Wan-Jin Jeon, Hyunseong Kim, Changhwan Yeo, Hyun Kim, Yoon Jae Lee, In-Hyuk Ha
Biomedicines.2025; 13(1): 192. CrossRef

Review Articles

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

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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.

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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

A Scoping Review of Clinical Research on Motion Style Acupuncture Treatment: Doori Kim, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2023;2(2):65-76. Published online June 23, 2023; DOI: https://doi.org/10.56986/pim.2023.06.001

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This scoping review was conducted to examine the concept of Motion style acupuncture treatment (MSAT), use in clinical practice, its effectiveness, and safety. A literature review of clinical study treatment methods combining acupuncture and movement therapy was performed using PubMed. Of 2,096 studies retrieved, 22 were included in this review. There were 12 randomized controlled trials, and all 22 studies were published in China and Korea, mostly, within the last 3 years. There were five studies concerning local acupoints and 17 studies regarding needling at distal acupoints, and the level of risk of the procedure was “high” in eight studies and “moderate” in 14 studies. The study participants were patients with musculoskeletal pain, and many studies reported significant improvements in pain and functional disability outcomes following treatment using MSAT. For conclusion, MSAT refers to a treatment method in which a patient performs active/passive movements under the supervision of a physician with the acupuncture needle retained at the insertion site. However, there are a limited number of MSAT studies, and various treatment types and related terms are mixed. Further studies, classification of the types of MSAT using a well-established classification system, and a clearer definition of the MSAT concept are needed.

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Effectiveness of lumbar motion style acupuncture treatment on inpatients with acute low back pain: A pragmatic, randomized controlled trial
Oh-Bin Kwon, Dong Wook Hwang, Dong-Hyeob Kang, Sang-Joon Yoo, Do-Hoon Lee, Minjin Kwon, Seon-Woo Jang, Hyun-Woo Cho, Sang Don Kim, Kyong Sun Park, Eun-San Kim, Yoon Jae Lee, Doori Kim, In-Hyuk Ha
Complementary Therapies in Medicine.2024; 82: 103035. CrossRef
Graded exercise with motion style acupuncture therapy for a patient with failed back surgery syndrome and major depressive disorder: a case report and literature review
Do-Young Kim, In-Hyuk Ha, Ju-Yeon Kim
Frontiers in Medicine.2024;[Epub] CrossRef
Effectiveness and Safety of Progressive Loading–Motion Style Acupuncture Treatment for Acute Low Back Pain after Traffic Accidents: A Randomized Controlled Trial
Seung-Yoon Hwangbo, Young-Jun Kim, Dong Guk Shin, Sang-Joon An, Hyunjin Choi, Yeonsun Lee, Yoon Jae Lee, Ju Yeon Kim, In-Hyuk Ha
Healthcare.2023; 11(22): 2939. CrossRef

Original Article

Evidence Map of Acupuncture: Where We Stand and Where We Should Go: Tae-Hun Kim, Jung Won Kang; Perspect Integr Med. 2024;3(2):106-113. Published online June 21, 2024; DOI: https://doi.org/10.56986/pim.2024.06.006

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2 Citations

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Background
Evidence mapping presents the current status of evidence on a specific field. The "Evidence Map of Acupuncture" published in 2014 gave an overall picture of the evidence on acupuncture treatments for various conditions/diseases. In this study, evidence in 2024 for the effect of acupuncture was reassessed.
Methods
The systematic reviews (SRs) on acupuncture for the 43 conditions/diseases where evidence was previously unclear or potentially effective in the "Evidence Map of Acupuncture" 2014 were searched in the PubMed and the Cochrane Library, and included SRs up to February, 2024. The Grading of Recommendations, Assessment, Development, and Evaluations assessment in the included SRs was used for assessing the confidence level in the evidence of each condition.
Results
When compared with the results of the "Evidence Map of Acupuncture" 2014, the average number of randomized controlled trials included in a SR increased from 11 to 19.5 by 2024. However, the confidence level showed an overall decrease. The reasons for unclear evidence were mainly methodological limitations such as poor research design, small sample size and small number of studies, and the results of the 2024 reassessment did not show a significant difference in the reasons compared with the "Evidence Map of Acupuncture" 2014.
Discussion
To improve clinical evidence for acupuncture, simple repetition and increasing the number of new randomized controlled trials does not seem to be effective. To reduce redundancy, large scaled studies should be conducted, and a new critical appraisal tool for acupuncture is needed to avoid unfair evaluation of risk of bias in acupuncture research.

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Citations to this article as recorded by

A Review of Key Research and Engagement in 2023–2024
John McDonald, Jonquil W. Pinto, Lin Ang, Sandro Graca
Journal of Integrative and Complementary Medicine.2025;[Epub] 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

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