Perspectives on Integrative Medicine

Protocols

Chinese Herbal Medicine Treatment for Restless Legs Syndrome: A Protocol for a Systematic Review with Meta-Analysis: Yadi Liu, Xiaoqin Wu, Yue Wang, Guoyan Yang, Di Wang, Yoann Birling; Perspect Integr Med. 2026;5(1):65-71. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.010

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Graphical Abstract Abstract PDF Supplementary Material: Background
Restless Legs Syndrome (RLS) significantly impairs sleep and daily life. Conventional treatments often cause side effects leading patients to seek alternative treatments like Chinese Herbal Medicine (CHM). A systematic review and meta-analysis of studies which used CHM treatment for RLS will facilitate the evaluation of its efficacy and safety.
Methods
Randomized controlled trials will be retrieved systematically from electronic databases including PubMed, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chongqing Value-added Information Platform. Comparisons between the effects of CHM (as monotherapy or adjunct therapy), placebos, and conventional interventions will be made. Two reviewers will independently perform study selection, data extraction, and risk of bias assessments using the Cochrane RoB 2.0 tool. The primary outcomes will be RLS symptom severity (e.g., IRLSSG rating scale), quality of life, and adverse events. Data will be pooled using a random-effects meta-analysis, and the overall certainty of evidence will be assessed for quality of evidence and strength of recommendation using the Grading of Recommendations, Assessment, Development, and Evaluation system.
Conclusion
This review aims to synthesize high-quality evidence to determine the effectiveness and safety of CHM treatment for RLS, provide valuable insights for clinicians, patients, and policymakers, and identify gaps for future research.

Traditional, Complementary, and Integrative Medicine Researcher Attitudes and Perceptions of Generative Artificial Intelligence Chatbots in the Scientific Process: A Protocol for a Large-Scale, International Cross-Sectional Survey: Jeremy Y. Ng, Jamie Tan, Karthik Adapa, Prashant Kumar Gupta, Shao Li, Darshan Mehta, Melinda Ring, Manisha Shridhar, João Paulo Souza, Tetsuhiro Yoshino, Myeong Soo Lee, Holger Cramer; Perspect Integr Med. 2026;5(1):59-64. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.009

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Graphical Abstract Abstract PDF: Background
Generative artificial intelligence (GenAI) chatbots can simulate conversations and perform tasks typically performed by humans, and offer novel research opportunities. Specifically, GenAI chatbots have shown utility in assisting with literature reviews, and interpreting large datasets, among other labor-intensive tasks. Traditional, complementary, and integrative medicine (TCIM) is a patient-centric approach that emphasizes holistic well-being. The integration of TCIM and artificial intelligence (AI) presents numerous key opportunities. However, TCIM researchers’ attitudes and perceptions of the role of GenAI tools in the scientific process remain less understood.
Methods
This protocol for a large-scale, international cross-sectional web-based survey was designed to elucidate the attitudes and perceptions of TCIM researchers regarding the use of GenAI chatbots in the research process. Emphasis will be placed on the advantages, limitations, and the ethical implications of GenAI chatbots use. The survey will be sent to TCIM researchers who have previously published in the field (anticipated 3%-7% response rate). It will include questions regarding demographic information, familiarity with AI chatbots, perceived benefits, and challenges of AI chatbots in the scientific process, and it will have several open-ended questions. Data will be analyzed using descriptive statistics.
Conclusion
By developing a deeper understanding of TCIM researchers' perspectives, future AI applications in this field can be more informed, enabling greater trust and acceptance surrounding the use of GenAI. Furthermore, findings from this survey will be integral to gaining insight into the perceived challenges of TCIM-driven AI, which will be vital in guiding future policies and collaborations among researchers.

Case Report

Acupuncture for Hearing Recovery in an Adolescent with Bilateral Sudden Sensorineural Hearing Loss: A Case Report: Narendra Lamichhane, Kamal Sharma, Ishwar Gyawali, Yuanzhen Yang, Lisa Dal Pozzo; Perspect Integr Med. 2026;5(1):52-58. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.008

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Graphical Abstract Abstract PDF: Sensorineural hearing loss (SNHL) is often irreversible and therefore is challenging to treat. Corticosteroids are primarily used as first line treatment within 3 days of onset. Acupuncture has been proposed as a complementary therapy that may enhance cochlear blood flow and modulate auditory pathways. A 15-year-old male suffered sudden bilateral SNHL and dizziness of unknown cause in the first week of January, 2025; he did not receive corticosteroids. Pure tone audiometry measurements were performed on January 26, 2025, and showed a baseline measurement of mild SNHL in the right ear and moderate SNHL in the left ear. He received acupuncture treatment at Tīnghuì (GB2), Tīnggōng (SI19), Ěrmén (SJ21), Yìfēng (SJ17), Jiăosŭn (SJ20), Shàngguān (GB3), and Tàiyáng (EX-HN5) acupoints for 40 minutes daily, for 15 days, then twice weekly for 6 weeks. Pure tone audiometry levels on February 9, 2025, showed improvement to bilateral mild SNHL, and by March 4, 2025, hearing had normalized in both ears. Dizziness resolved within 1 week with no recurrence. No adverse events were reported. Early, targeted acupuncture may be temporally associated with improvement in hearing in this patient. This is a single case report so causality cannot be determined. While acupuncture may have contributed to the patient’s recovery, fluctuating or spontaneous recovery remains a plausible explanation. These findings highlight the potential for an association, and support the need for further controlled studies to investigate the effects of acupuncture on SNHL.

Original Articles

Anxiolytic Effect of Acupuncture Treatment for Anxiety Compared with Phytotherapy: A Randomized Clinical Trial in Brazil: Talita Bonato de Almeida, Maria Imaculada de Lima Montebelo, Godofredo Pignataro Neto, Maria da Luz Rosário de Sousa; Perspect Integr Med. 2026;5(1):43-51. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.007

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Graphical Abstract Abstract PDF: Background
Anxiety is the most common psychological disturbance; therefore, safe, and effective therapeutic options are necessary for managing the associated symptoms. The aim of this study was to assess the anxiolytic effect of acupuncture, and phytotherapeutic Valerian officinalis in anxious patients.
Methods
The trial was a participant- and assessor-blinded, parallel clinical study with 64 anxious patients who were randomized into 4 study groups. All patients, upon attendance at the clinic, were asked to lie down and perform abdominal breathing. In total, the volunteers in Real Acupuncture Group received 5 sessions of acupuncture while those of the Placebo Acupuncture Group received no intervention. In total, the volunteers in Real Phytotherapy Group received 28 capsules of V. officinalis and the Placebo Phytotherapy Group, 28 inert capsules. Anxiety was measured using the Visual Analogue Scale and State-Trait Anxiety Inventory, and Ryodoraku and Bioelectrography were used for energy analysis.
Results
After 5 weeks, analysis of the Visual Analogue Scale scores, all groups achieved a statistically significant reduction in levels of anxiety and the Real Acupuncture showed a large effect. All groups showed a reduction in the State-Trait Anxiety Inventory score, with the sub-item, “State in Real Acupuncture” being important. Ryodoraku showed the electrical properties values of the skin and with Bioelectrography indicated generally low energy that decreased further following use of the therapies.
Conclusion
Acupuncture was effective in reducing patients' anxiety and had a larger effect size than V. officinalis, therefore it could be offered as an alternative treatment for anxiety management.

Type of Work and Subjective Health Components: A Nationwide Cross-Sectional Survey Among Workers in Korea: Min Kyung Hyun; Perspect Integr Med. 2026;5(1):36-42. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.006

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Graphical Abstract Abstract PDF Supplementary Material: Background
This study examined how type of work and working conditions (such as shift work and long working hours) are associated with subjective health components including health-maintenance behaviors, health-related quality of life (HRQOL), and self-management strategies for maintaining health among Korean workers.
Methods
A nationwide cross-sectional online survey was conducted in November 2021 among adults aged 20-64 years from 17 regions of the Republic of Korea (N = 3,900). Participants were categorized into unpaid family workers, irregular workers, self-employed workers, and permanent employee workers (n = 3,275). Paid workers were subcategorized into shift work (n = 574) and weekly working hours over 41 hours (n = 932). Among the subjective health components, HRQOL and self-management strategies for maintaining health were assessed using tools with proven validity and reliability. Descriptive and multivariate logistic regression analyses were performed.
Results
Adequate rest, as a health maintenance behavior, was determined to have a statistically significant association with type of work, shift work, and working hours. Shift work and working over 41 hours per week were positively associated with the use of preparation strategies, with adjusted odds ratios of 1.052 [95% confidence interval (CI): 1.015-1.090] and 1.035 (95% CI: 1.005-1.067), respectively. Furthermore, shift work negatively correlated with HRQOL (aOR = 0.026, 95% CI: 0.009-0.070).
Conclusion
Subjective health components were influenced by differences in type of work, and working conditions. Utilizing this information to develop indicators for worker health management within Korean medicine and integrative medicine may contribute to efficient health management of workers.

Maimendong-Tang Treatment for Subacute and Chronic Cough in a Primary Care Korean Medicine Clinic: Jungah Uhm, Jungtae Leem, Jihyun Hwang, Kwan-Il Kim, Sungduk Hong, Dasol Park; Perspect Integr Med. 2026;5(1):28-35. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.005

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Graphical Abstract Abstract PDF Supplementary Material: Background
Despite guideline-based evaluation of identifiable causes, many patients still have refractory or unexplained chronic cough, highlighting the need for adjunctive therapies. Real-world clinical evidence for Maimendong-Tang (MMDT) in primary Korean medicine is scarce.
Methods
Medical records from 1 primary Korean medicine clinic were retrospectively reviewed. Adults with subacute or chronic cough who received MMDT for ≥ 2 weeks were included in the study. Outcomes were improvement in severity for cough and sputum. The data were summarized descriptively, cumulative proportions achieving ≥ 50% and ≥ 3-point cough-NRS reductions were calculated by visit and cough type, and exploratory k-means clustering (Jaccard distance) was performed, and herb-symptom bipartite networks were assessed.
Results
Thirty-one patients were included (mean age 53.6 ± 14.8; 90% female; 14 subacute, 17 chronic). Inter-visit medians (IQR) were 35.5 (32.0-49.5), 34.5 (33.2-43.5), and 34.0 (34.0-42.0) days for Visits 1-2, 2-3, and 3-4. Cough NRS scores decreased from 7.95 ± 1.04 at Visit 1 to 3.14 ± 1.87 at Visit 2 (subacute 8.21 ± 0.97 → 2.58 ± 1.46; chronic 7.74 ± 1.06 → 3.63 ± 2.09), and sputum NRS scores from 3.18 ± 2.51 to 1.68 ± 1.72. By Visit 2, 67.7% achieved ≥ 50% cough reduction (subacute 85.7%; chronic 52.9%). No adverse events were observed. Clustering and herb-symptom networks showed no meaningful prescription-pattern differences by co-occurring symptoms; subacute- and chronicstratified networks resembled the overall network.
Conclusion
MMDT prescription may be associated with a decrease in cough and sputum severity. Due to risk of bias, generalizability is limited; however, demographics, clinical characteristics, and treatment patterns, may provide foundational data for large-scale prospective studies.

Effectiveness and Safety of Integrative Korean Medicine Treatment for Cervical Disc Herniation with Radiculopathy: One-year Follow-up Results of a Prospective Observational Study: Su Won Lee, Yong-jun Ahn, Suna Kim, Yeonsun Lee, Hyun-Woo Cho, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2026;5(1):17-27. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.004

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Graphical Abstract Abstract PDF Supplementary Material: Background
Cervical disc herniation (CDH) often accompanies radiculopathy causing pain in the neck and upper extremities that interferes with daily life. The prevalence of CDH is increasing. The treatment methods recommended are primarily conservative.
Methods
In this prospective, single-arm, multicenter, observational study there were 120 patients diagnosed in the past 12 months with CDH (disc protrusion or more severe conditions) accompanied by radiculopathy. Patients received integrative Korean medicine treatment (acupuncture, electroacupuncture, pharmacopuncture, herbal medicine, cupping therapy, and Chuna therapy), approximately twice a week for 2 months, and outcomes were measured. The numeric rating scale, and visual analog scale were used for assessing neck and arm pain, and the neck disability index, patient global impression of change, EuroQol-5-dimension, work productivity and activity impairment questionnaire, and range of motion assessed how pain affected daily activities.
Results
Out of 120 patients, 115 completed 2-months treatment, and 114 responded at the 1-year follow-up. The numeric rating scale score for neck or arm pain showed a reduction of 3.96 points (95% CI, 3.63, 4.29) from baseline to 8 weeks, which further improved (95% CI, 4.09, 4.75) at 1 year. Similarly, the visual analog scale score for neck and arm pain, quality of life measures, and function-related measures also showed improvement from baseline, maintaining these gains at 1 year.
Conclusion
This observational study suggested that using Korean medicine treatment, a conservative treatment method, as the intervention, may provide long-term benefits in reducing pain and improving function and quality of life for patients with CDH accompanied by radiculopathy.

Review Article

Phytochemical Mechanisms of Action Against Obesity and Strategies to Overcome Limitations: Ngoc Han Le Thi, So Yeon Park, Juni Lee, Ye-Seul Hwang, Seong-Jin Kim, Ye-Jeong Choi, Mi-Hyang Kim, Ki Sung Kang; Perspect Integr Med. 2026;5(1):7-16. Published online February 11, 2026; DOI: https://doi.org/10.56986/pim.2026.02.003

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Graphical Abstract Abstract PDF: Phytochemicals - natural compounds such as synephrine, curcumin, capsaicin, and saponins - have gained significant attention for their potential anti-obesity effects through modulation of lipid metabolism and adipogenesis. Synephrine derived from Citrus aurantium exerts its anti-obesity effects by inhibiting adipogenesis (3T3-L1) and enhances fat oxidation through the adenosine monophosphate-activated protein kinase - forkhead box protein O1 signaling pathway. Similarly, curcumin, which is a polyphenolic compound from Curcuma longa, promotes fatty acid oxidation, inhibits preadipocyte differentiation, and modulates insulin resistance and hyperlipidemia. Capsaicin from Capsicum species, induces the browning of adipose tissue and enhances fat oxidation by activating channels, increasing sirtuin-1 expression, and promoting lipid catabolism. Saponins regulate fat absorption by inhibiting pancreatic lipase and modulate adipogenesis through the adenosine monophosphate-activated protein kinase signaling pathway, further contributing to the suppression of obesity. However, the clinical application of these phytochemicals is often limited by factors such as bioavailability, solubility, and potential toxicity. In this narrative review, the mechanisms by which these compounds affect metabolic pathways related to adipogenesis and lipid metabolism are discussed, as well as the challenges faced in their therapeutic use and potential strategies to overcome these limitations.

Commentary

Integrating Mongolian Mind-Body Interaction Therapy with Modern Systems Theory: A Holistic Approach to Psychosomatic Medicine: Narisu De, Caihela Hushud, Xianghui Bai, Nagongbilige , Wuliji Che, Hongyun Wu, Jun Fang, Wenfeng Bao, Baojun De, Narengerile Tong, Bo Cui, Lina Yang, Yiligema Ge, Siqintonglaga Wang, Vrajesh Mehta, Qiong Hu, Yu Du; Perspect Integr Med. 2025;4(3):213-216. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.010

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Graphical Abstract Abstract PDF: This commentary explores the synergistic integration of Mongolian Mind-Body Interaction Therapy (MMBIT) with modern Systems Theory to offer a roadmap for advancing integrative psychosomatic care. By blending traditional Mongolian medical wisdom (Heyi/Xila/Badagan?triad) with interdisciplinary systems science, MMBIT provides a holistic framework for treating mind-body disorders through its Material-Energy-Information Triadic Interaction Model. This commentary highlights the theoretical foundations, clinical applications, and technological innovations of MMBIT, demonstrating its potential to transform integrative medicine and global healthcare practices.

Guidelines

Reporting Guidelines for Music-Based Interventions: An update and Validation Study: Sheri L. Robb, Stacey Springs, Emmeline Edwards, Tasha L. Golden, Julene K. Johnson, Debra S. Burns, Melita Belgrave, Joke Bradt, Christian Gold, Assal Habibi, John R. Iversen, Miriam Lense, Jessica A. MacLean, Susan M. Perkins; Perspect Integr Med. 2025;4(3):205-212. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.009

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Graphical Abstract Abstract PDF Supplementary Material: Background
Detailed intervention reporting is essential to interpretation, replication, and translation of music-based interventions (MBIs). The 2011 Reporting Guidelines for Music-Based Interventions were developed to improve transparency and reporting quality of published research; however, problems with reporting quality persist.
Methods
The purpose of this study was to update and validate the 2011 reporting guidelines using rigorous Delphi approach that involved an interdisciplinary group of MBI researchers; and to develop an explanation and elaboration guidance statement to support dissemination and usage. We followed the methodological framework for developing reporting guidelines recommended by the EQUATOR Network and guidance recommendations for developing health research reporting guidelines. Our three-stage process included: (1) an initial field scan, (2) a consensus process using Delphi surveys (two rounds) and Expert Panel meetings, and (3) development and dissemination of an explanation and elaboration document.
Results
First-Round survey findings revealed that the original checklist items were capturing content that investigators deemed essential to MBI reporting; however, it also revealed problems with item wording and terminology. Subsequent Expert Panel meetings and the Second-Round survey centered on reaching consensus for item language. The revised RG-MBI checklist has a total of 12-items that pertain to eight different components of MBI interventions including name, theory/scientific rationale, content, interventionist, individual/group, setting, delivery schedule, and treatment fidelity.
Conclusion
We recommend that authors, journal editors, and reviewers use the RG-MBI guidelines, in conjunction with methods-based guidelines (e.g., CONSORT) to accelerate and improve the scientific rigor of MBI research.

Reporting Guidelines for Music-Based Interventions Checklist: Explanation and Elaboration Guide: Sheri L. Robb, K. Maya Story, Elizabeth Harman, Debra S. Burns, Joke Bradt, Emmeline Edwards, Tasha L. Golden, Christian Gold, John R. Iversen, Assal Habibi, Julene K. Johnson, Miriam Lense, Susan M. Perkins, Stacey Springs; Perspect Integr Med. 2025;4(3):190-204. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.008

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Graphical Abstract Abstract PDF Supplementary Material: Background
Detailed intervention reporting is essential to interpretation, replication, and eventual translation of music-based interventions (MBIs) into practice. Despite availability of Reporting Guidelines for Music-based Interventions (RG-MBI, published 2011), multiple reviews reveal sustained problems with reporting quality and consistency. To address this, we convened an interdisciplinary expert panel to update and improve the utility and validity of the existing guidelines using a rigorous Delphi approach. The resulting updated checklist includes 12-items across eight areas considered essential to ensure transparent reporting of MBIs.
Methods
The purpose of this explanation and elaboration document is to facilitate consistent understanding, use, and dissemination of the revised RG-MBI. Members of the interdisciplinary expert panel collaborated to create the resulting guidance statement.
Results
This guidance statement offers: (1) the scope and intended use of the RG-MBI, (2) an explanation for each checklist item, with examples from published studies, and (3) 2 published studies with annotations indicating where the authors reported each checklist item.
Conclusion
Broader uptake of the RG-MBIs by study authors, editors, and peer reviewers will lead to better reporting of MBI trials, and in turn facilitate greater replication of research, improve cross-study comparisons and meta-analyses, and increase implementation of findings.

Protocol

Study Protocol for a Randomized Pragmatic Clinical Trial Evaluating Pharmacopuncture Versus Acupuncture for Chronic Neck Pain: Ju Yeon Kim, Suna Kim, Yeonsun Lee, Hyun-Woo Cho, Yejin Hong, Dongwoo Nam, Yeoncheol Park, Eun-Jung Kim, Sook-Hyun Lee, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2025;4(3):181-189. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.007

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Graphical Abstract Abstract PDF Supplementary Material: Background
Neck pain is a common musculoskeletal disorder, which is becoming increasingly common with the rise in computer and smartphone use. For many, this condition leads to chronic discomfort, and disability in daily life. Although pharmacopuncture represents a major treatment modality for neck pain in Korean medicine, its effectiveness and safety as compared with standard acupuncture has not been thoroughly investigated.
Methods
A study protocol for a multicenter, pragmatic, randomized clinical trial was designed with a parallel-group approach. A total of 128 participants, each experiencing chronic neck pain for at least 3 months, will be recruited. Participants will be randomly assigned to either the pharmacopuncture or acupuncture group and receive treatment twice weekly for 4 weeks. The primary outcome will be the change in score for neck pain, as assessed using the numeric rating scale, 5 weeks after baseline. Secondary outcomes will include evaluations using the visual analog scale, Northwick Park Questionnaire, Neck Disability Index, Patient Global Impression of Change, Health-Related Quality of Life Instrument with eight items, and the EuroQol-5 Dimension. In addition, a cost-effectiveness analysis will be conducted and reported separately.
Discussion
The rigorous study design is intended to ultimately provide practical evidence for clinicians and policymakers regarding the use of pharmacopuncture treatment for chronic neck pain. By directly comparing its effectiveness with standard acupuncture, the results of the trial outcomes will offer insights that may inform future healthcare decisions. Trial registration: This protocol has been registered at ClinicalTrials.gov (NCT06520462) on July 25, 2024.

Case Reports

Integrating Traditional East Asian Medicine Dietary and Herbal Therapies for Supporting Cancer Treatment and Survivorship in the West: Michelle Loy, John K Chen; Perspect Integr Med. 2025;4(3):171-180. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.006; Correction in: Perspect Integr Med 2026;5(1):72

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Graphical Abstract Abstract PDF: Traditional East Asian Medicine (TEAM) dietary and herbal therapies emphasize balance, nourishment, and resilience, and have long supported cancer care in Asia. In Western integrative oncology, these therapies are increasingly being used to manage side effects, enhance quality of life, and support survivorship. This retrospective study included patients to illustrate the integration of TEAM therapies in Western academic settings. Case 1, was an 84-year-old woman with Stage 4 bladder and kidney cancer who discontinued immunotherapy due to the side effects of treatment (dietary and herbal). A TEAM-informed dietary and herbal formulas plan was implemented alongside integrative group visits. Case 2, was a 65-year-old woman with metastatic breast cancer experiencing endocrine therapy-related insomnia. She was treated with Suan Zao Ren Tang and a comprehensive sleep support plan (dietary, herbal, and cancer-related medications - i.e letrozole, abemaciclib, and zoledronic acid). In Case 1, the patient gained 3.2 kg, her foot ulcers healed, sleep and mobility improved, and she transitioned from using a wheelchair to using walker. In Case 2, the patient reported improved sleep within weeks of using Suan Zao Ren Tang, she discontinued use after 4 months, and 2 months later, she had maintained restful sleep without recurrence of insomnia. Both patients experienced enhanced quality of life, and treatment adherence without adverse effects. These cases highlight the potential of personalized, culturally sensitive TEAM dietary and herbal therapies to support symptom management and survivorship in cancer care. Integrative approaches combining traditional and modern modalities can improve patient outcomes and quality of life, even in advanced stages of disease.

Korean Medicine Treatment for Facial Palsy During Pregnancy: Case Report: Min-Jeong Kwon, Su-na Park, Ga Yeong Yi, Jae-kyoung Lee, Jae-Joong Jung, Su-Ji Choi, YeonSun Lee; Perspect Integr Med. 2025;4(3):164-170. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.005

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Graphical Abstract Abstract PDF Supplementary Material: Facial palsy during pregnancy often has a poor prognosis. Korean medicine treatment for facial palsy is considered safe and effective in pregnant women. Two cases of pregnant women with facial palsy who visited Bucheon Jaseng Korean Medicine Hospital and received Korean medicine treatment were retrospective analyzed. The treatment was applied to the affected side of the face using the points that are most widely used for facial palsy. The recovery outcomes were graded using the gross grading system Yanagihara scale, House-Brackmann scale, and the numeric rating scale. Both cases showed improvement in facial palsy symptoms. The House-Brackmann scale grade in Case 1 improved from Grade 4 to 2 (mild dysfunction), and in Case 2 from Grade 5 to 2 (mild dysfunction), and the numeric rating scale score in Case 1 improved from 6 to 0 points (no pain) and in Case 2 from 4 to 2 (mild pain). The Yanagihara scale total score also showed improvement increasing from 14 to 40 points (normal function) in Case 1 and 9 to 34 (mild dysfunction) in Case 2. Completion of treatment in Case 1 was on 46 days since onset and in Case 2 it was on 38 days since onset. Korean medicine treatment including acupuncture, pharmacopuncture, moxibustion, cupping, and Chuna (applied early) can be used as an alternative treatment to steroids in facial palsy during pregnancy.

Review Articles

Role of Acupuncture on the Brain-Gut-Joint Axis in Osteoarthritis: Jae-Hwan Jang, Seok Hee Han, Yurim Song, Ju-Young Oh, Hi-Joon Park; Perspect Integr Med. 2025;4(3):153-163. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.004

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Graphical Abstract Abstract PDF Supplementary Material: Osteoarthritis (OA) is a predominantly degenerative disease with heterogeneous phenotypes, including subsets with low-grade inflammation. Emerging data suggest that the gut microbiota may contribute to OA biology. While noting that definitive, longitudinal links between acupuncture-induced microbiome modulation and joint outcomes are yet to be established clinically, acupuncture has been associated with symptomatic improvement of OA alongside immune and microbiome changes. Within a brain-gut-joint framework, preclinical, and mechanistic studies (N = 13) were assessed in this scoping review. The neuro-immune pathways, such as the vagal–adrenal/splenic, and sympatho–adrenal/splenic axes, when activated by acupuncture, can modulate gut microbial composition. These activated pathways likely involve the vagus nerve (a component of the parasympathetic nervous system) and the sympathetic nerves (which are connected to gastrointestinal-related organs, including the adrenal gland, spleen, and gut). Acupuncture may also activate the neuroendocrine system via the hypothalamic–pituitary–adrenal axis, which regulates stress, thereby releasing hormones that contribute to anti-inflammatory effects. Acupuncture may support the treatment and management of OA via the brain-gut-joint axis. Given that acupuncture is associated with fewer side effects than conventional medications, it represents a promising therapeutic strategy for OA.

A Scoping Review of the Anti-Inflammatory Effects of Hwangryunhaedok-tang: Mechanism-Based Biomarkers: Sung Jin Kim, Yea Jung Choi, Dayeon Ham, Mei Tong He, Ki Sung Kang; Perspect Integr Med. 2025;4(3):141-152. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.003

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2 Citations

Graphical Abstract Abstract PDF

Hwangryunhaedok-tang (HLHDT) is a traditional Korean and Chinese medicinal formula known for its anti-inflammatory properties. This study evaluated the breadth of HLHDT’s therapeutic potential by analyzing literature on its anti-inflammatory effects. A database search (PubMed and CNKI) retrieved 2,013 relevant articles, of which 48 papers were selected for systematic review. Clinical studies showed its effectiveness in treating various inflammatory conditions, including radiation dermatitis, atopic dermatitis, ulcerative colitis, diabetic foot infections, periodontitis, oral diseases, and acute viral myocarditis. The analysis revealed that HLHDT effectively modulated inflammation across models including suppression of inflammatory pathways in lipopolysaccharide-treated A549 cells, and showing autophagy-related effects in RAW 264.7 cells. In addition, research on conditions such as atopic dermatitis, atherosclerosis, and acute lung injury determined its efficacy in treating a range of inflammatory diseases. The capacity of HLHDT to significantly reduce many proinflammatory markers underscored its extensive anti-inflammatory effects, and highlighted its potential in addressing both acute and chronic inflammatory conditions. However, the predominance of studies conducted in China and variability in methodological quality may limit the generalizability of the findings. Therefore, there is a need for further clinical research to validate the effects of HLHDT, and explore its underlying mechanisms of action. This study demonstrated the potential of HLHDT as a significant therapeutic agent in traditional Chinese medicine.

Citations

Citations to this article as recorded by

Promotion of glucose uptake by mulberry leaf extract and its active component 1-deoxynojirimycin in C2C12 cells
Ngoc Han Le Thi, Jun Hyung Park, Min Ji Han, Seon Hwa Kim, Tae Hoon Kim, Dong-Wook Kim, Seung Hyun Kim, Ki Sung Kang
Applied Biological Chemistry.2026;[Epub] CrossRef
Safety and Effects of WON-21, herbal medicine combination, on blood ethanol and acetaldehyde levels in ethanol administered rats
Ji Hwan Lee, So Hyeon Kim, Mihyang Kim, Won Sang Huh, Jaesung Pyo, Ki Sung Kang
Journal of Korean Medicine.2025; 46(4): 127. CrossRef

Acupuncture and Herbal Medicine Treatment in Cancer Care: A Scoping Review Focused on European Regions: Kwonwoo Park, Jeong Su Park, Minji Kim, Gyumi Park, Yujin Lee, Hakyung Lee; Perspect Integr Med. 2025;4(3):131-140. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.002

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Graphical Abstract Abstract PDF Supplementary Material: Acupuncture and herbal medicine have traditionally been used in East Asia for cancer care. This study aimed to explore how acupuncture and herbal medicine in cancer treatment is used in Europe to identify the common cancer types treated, therapeutic methods applied, and patient satisfaction. This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline and Arksey and O’Malley’s methodological framework. Literature searches were conducted using electronic databases and 2 complementary and alternative medicine-focused journals. The inclusion criteria included first author’s affiliation in Europe and use of acupuncture or herbal medicine in cancer treatment. The exclusion criteria included focusing solely on chemotherapy-related adverse effects or in vitro research. From 6,109 initial records, 6 studies met the inclusion criteria. Two studies involved acupuncture, and 4 involved herbal medicine. Breast cancer was the most frequently studied and ST36 was the most frequently used acupuncture point. Herbal medicines included mistletoe extract and Ruta graveolens. Reported outcomes included symptom relief and generally positivity, although findings varied. This scoping review identified a limited but emerging body of cancer research on the use of acupuncture and herbal medicine in Europe. Highquality clinical research is needed.

Editorial

Adapt or Lag Behind: Why Researchers in Traditional, Complementary, and Integrative Medicine Must Master Prompt Engineering in the Era of Artificial Intelligence: Jeremy Y. Ng; Perspect Integr Med. 2025;4(3):127-130. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.001

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Graphical Abstract PDF

Protocols

Artificial Intelligence in the Editorial and Peer Review Process: A Protocol for a Cross-Sectional Survey of Traditional, Complementary, and Integrative Medicine Journal Editors’ Perceptions: Jeremy Y. Ng, Daivat Bhavsar, Neha Dhanvanthry, Myeong Soo Lee, Ye-Seul Lee, Tanuja M. Nesari, Thomas Ostermann, Claudia M. Witt, Linda Zhong, Holger Cramer; Perspect Integr Med. 2025;4(2):121-124. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.008

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Graphical Abstract Abstract PDF Supplementary Material: This research protocol outlines a cross-sectional survey study, aimed at editors from traditional, complementary, and integrative medicine (TCIM) journals, regarding their perceptions of the use of artificial intelligence (AI) in the editorial and peer review process. The survey will be sent to editors-in-chief, associate editors, and editorial board members of TCIM journals (100-150). The research involves purposive sampling via manual collection of contact details from TCIM journal websites. The survey will include sections on demographics, current use and familiarity with AI, perceived benefits and challenges, ethical concerns, and the outlook for AI in publishing. Data collection will be conducted online using SurveyMonkey whereby email invitations and follow-up reminders will be sent to potential respondents. Quantitative data will be analyzed using descriptive statistics, and for qualitative data, thematic analyses will be employed. This protocol study aimed to devise a survey which could provide insight into the acceptance and potential barriers to AI adoption in TCIM publishing from an editor’s perspective. The results of which may later guide the development of AI tools in a way that aligns with the needs and values of the TCIM research community.

A Study Protocol for Developing a Consensus-Based Reporting Guideline for Case Reports on Acupuncture-Related Adverse Events: Tae-Hun Kim, Ye-Seul Lee, Jung-Won Kang, Myeong Soo Lee, Lin Ang, Jeremy Y. Ng, Stephen Birch, Terje Alræk, Lin Yu, Yuting Duan, Zhirui Xu; Perspect Integr Med. 2025;4(2):117-120. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.007

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Graphical Abstract Abstract PDF Supplementary Material

Case reports play a crucial role in identifying safety concerns related to new or rare complications and adverse events (AEs) associated with therapeutic interventions. Although acupuncture is generally considered safe when performed by trained professionals, the increasing number of case reports reporting acupuncture-related AEs has raised public safety concerns. A recent systematic review of case reports from 2010 to 2023 determined that many reports lacked the essential details necessary for assessing AE causality, treatment appropriateness, and contributing risk factors. These omissions may result in misinformation, and exaggerate the potential harm of acupuncture. The CAse REport guidelines (13 items) provide general guidance to improve the clarity, completeness, and transparency of case report findings, but they do not address the unique clinical features and factors specific to acupuncture-related AEs such as defective needles, practitioner malpractice, or patient-related factors. These limitations may hinder the educational value of such reports in preventing acupuncture-related AEs. To address this gap, a consensus-based reporting guideline tailored to acupuncture-related AEs is necessary to enhance the quality, transparency, and reliability of case reports, which will ultimately contribute to improved patient care. This article outlines a protocol, and approaches, for developing a reporting guideline for acupuncture-related AEs in case reports.

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REporting Guidelines for aCupuncture‐Related AdverSe Event Case Reports (RECASE): Elaboration and Explanation
Ye‐Seul Lee, Tae‐Hun Kim, Jung‐Won Kang, Lin Ang, Jeremy Y. Ng, Stephen Birch, Terje Alræk, Lin Yu, Yuting Duan, Zhirui Xu, Myeong Soo Lee
Journal of Evidence-Based Medicine.2025;[Epub] CrossRef

Case Report

Delivery of Telemedicine to Manage Cardiac Palpitations with Herbal Medicine in a Patient with Premature Ventricular Complexes Following Catheter Ablation for Atrial Fibrillation: Jimin Kim, Hyungsun Jun, Jungtae Leem, Hyeryun Lee, Chul-Woo Ahn, Dasol Park; Perspect Integr Med. 2025;4(2):110-116. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.006

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Graphical Abstract Abstract PDF: A patient living abroad who underwent catheter ablation for atrial fibrillation 3 years ago experienced recurrent arrhythmia symptoms 3 months ago and was diagnosed with premature ventricular complexes (PVCs) confirmed by Holter monitoring. He was advised to undergo repeat catheter ablation, however, he sought traditional Korean medicine (TKM) treatment advised via telemedicine. He reported continuous irregular heartbeats [numeric rating scale (NRS) score 10]. He was started on Yixin Tang, and by the 3^rd day of administration his symptoms of irregular heartbeats had disappeared (NRS 0) and did not return during the subsequent 320-day observation period. Pain caused by tightness in the chest and throat (NRS 8) did not show improvement despite various prescriptions; a noncardiac etiology, likely gastrointestinal, was suspected. Heart failure as measured by NT-pro BNP levels, was consistently elevated borderline, around 130 pg/mL, (possible heart failure), and on Day 320 it was normal measuring 50 pg/mL (heart failure less likely). No serious adverse events were reported following TKM treatment. This case suggests the potential value of TKM remote treatment in meeting the unmet needs of arrhythmia patients. Further research, including controlled clinical trials and development of telemedicine-specific guidelines, is warranted.

Short Communication

A Novel Hypothesis for Integrating Cupping Therapy in Spasticity Management: Bryn Hager, Faye Akin, Samuel Brant, Joshua Lopez, Camden Roth; Perspect Integr Med. 2025;4(2):103-109. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.005

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Graphical Abstract Abstract PDF: Spasticity, a common consequence of neurological injuries, negatively affects function and quality of life. Despite the availability of pharmacological and therapeutic interventions, limitations remain in accessibility, cost, side effects, and long-term efficacy of treatments. Cupping therapy, a traditional intervention, historically used for pain relief and circulation, may offer novel benefits in reducing spasticity. In this short communication, hypothesized mechanisms are presented through which cupping therapy may modulate both central and peripheral mechanisms of spasticity, as well as clinical relevance, should this hypothesis be validated. This is not a review or evidence summary, but a conceptual hypothesis grounded in emerging evidence. We propose that cupping therapy is an underutilized, yet promising strategy in neurological rehabilitation, warranting further exploration and empirical validation. This hypothesis supports the need for controlled trials comparing cupping with standard spasticity interventions. If validated, cupping may offer a low-cost, low-risk addition to the neurorehabilitation toolkit.

Original Article

Apamin Mitigates Oxidative Stress-Induced Nucleus Pulposus Cell Death Through Regulation of Nrf2 and HO-1 Pathways: Hyunseong Kim, Hwan-Suck Chung, Hyunsu Bae; Perspect Integr Med. 2025;4(2):96-102. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.004

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Graphical Abstract Abstract PDF

Background
Intervertebral disc degeneration is driven by the decline of nucleus pulposus (NP) cells and oxidative stress plays a key role in extracellular matrix disruption and progression of the condition. Apamin, a bioactive peptide derived from bee venom is neuroprotective and anti-inflammatory, but its effect on NP cells under oxidative stress is unknown.
Methods
Human NP cells were cultured, pretreated with apamin, and exposed to 200 μM H₂O₂ (causing oxidative stress). Reactive oxygen species (ROS) levels, disc degeneration markers, and the regulation of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) signaling pathways were assessed using immunocytochemistry and fluorescence-activated cell sorting analysis.
Results
Apamin protected NP cell viability under oxidative stress at the optimal concentrations between 10-50 μg/mL. As a percentage relative to untreated control, apamin significantly inhibited the production of ROS (induced by H₂O₂) and the expression of Nrf2 and HO-1 (key regulators of the antioxidant response) was higher relative to the control. The expression of aggrecan and collagen Type 2 alpha 1 (essential components of the extracellular matrix) was higher relative to the control, while the expression of disc degeneration-related markers, including matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) was lower compared with the control.
Conclusion
In vitro, apamin protects human NP cells from oxidative stress-induced death by inhibiting levels of ROS and activating the Nrf2 and HO-1 pathways. These results suggest potential for apamin as a therapeutic antioxidant agent for intervertebral disc degeneration.

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Pullulan-based polymeric nanosystem for KEAP1 siRNA delivery: Mitigating ROS and promoting wound healing in vitro
Gülşen Bayrak, Dilara Karaguzel, Cagatay Karaaslan, Işık Perçin
Colloids and Surfaces B: Biointerfaces.2026; 260: 115352. CrossRef

Review Articles

Evaluating the Efficacy of Warm Acupuncture and Electroacupuncture in Temporomandibular Disorder: A Narrative Review: Lisa Dal Pozzo, Secondo Scarsella, Maria Abad Arranz; Perspect Integr Med. 2025;4(2):87-95. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.003

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Graphical Abstract Abstract PDF Supplementary Material: Temporomandibular disorder (TMD) causes jaw pain, difficulty speaking/eating, and discomfort referred to the head, neck, and shoulders. Western treatments (anti-inflammatory drugs, opioids, muscle relaxants) may have side effects or may be unsuitable for older adults due to polypharmacy risks. Nonpharmacological options like physiotherapy and magnetic therapy are promising, but acupuncture, rooted in Traditional Chinese Medicine, has gained attention for its efficacy. Traditional Chinese medicine attributes TMD to Qi stagnation, blood stasis, and pathogenic factors (cold, wind, dampness), leading to pain and stiffness. Acupuncture reduces pain, improves jaw mobility, and decreases joint noises, and has long-term benefits and low recurrence of TMD. Techniques like warm acupuncture and electroacupuncture lower inflammation and alleviate local/distal symptoms. This review compiles studies on acupuncture’s role in TMD treatment (mono or combined therapy) and draws from Western and Chinese databases. Acupuncture offers a safe, effective alternative, particularly for patients where conventional drugs are unsuitable.

Systematic Review of Preclinical Evidence on Parenteral Administration of Schizonepeta Tenuifolia Sole Extract: Chaeheon Lee, Jihwan Choi, Ji Eun Choo, Ga Ram Yang, Hyung-Cheal Mun, Won Gun An, Cheol-Hyun Kim, Jaehyo Kim, Sangkwan Lee, Hongmin Chu; Perspect Integr Med. 2025;4(2):76-86. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.002

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Graphical Abstract Abstract PDF Supplementary Material: While steroids effectively control inflammation, their long-term use causes severe side effects, necessitating safer alternatives. Schizonepeta tenuifolia (S. tenuifolia) from the Lamiaceae family demonstrates potential as a natural therapeutic option through its anti-inflammatory and antiviral properties. This systematic review analyzed in vivo and in vitro studies of S. tenuifolia extract, focusing on non-oral administration routes to evaluate its therapeutic potential (n = 13). The extract effectively inhibited nuclear factor kappa-light-chain-enhancer of activated B cells and mitogen-activated protein kinase pathways, reduced inflammatory cytokine production, and showed antiviral effects. Additional benefits include wound healing and antiplatelet activity which enables targeted inflammation control without systemic immune suppression. The extract showed promise in conditions requiring targeted pathway modulation, such as inflammatory conditions needing selective cytokine inhibition, viral infections where interferon modulation is beneficial, and disorders with dysregulated mitogen-activated protein kinase signaling. These effects were achieved without the systemic immunosuppression typical of steroid treatments. While S. tenuifolia extract could serve as a safer alternative through non-oral administration routes, further research is needed to optimize extraction methods, identify key marker compounds, and determine optimal administration routes including topical administration and injectable formulations.

A Bibliometric Analysis of Studies on Meridians: Chan-Young Kwon; Perspect Integr Med. 2025;4(2):67-75. Published online June 23, 2025; DOI: https://doi.org/10.56986/pim.2025.06.001

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Graphical Abstract Abstract PDF Supplementary Material: A meridian is a channel through which qi moves and is a key concept in traditional East Asian medicine. Meridian studies have evolved from classical functional to modern scientific investigations. This study was performed to construct, analyze, and visualize research trends in modern scientific investigations through a bibliometric analysis. The MEDLINE database was searched via PubMed. All relevant studies published up to December, 2024 were included (N = 1,446). Research on the concept of meridians has been actively reported since the early 1990s, peaking in 2015 (n = 103). Various biological basis for meridians, including the primo vascular system, have been investigated throughout this period. Co-occurrence analysis identified 3 major research clusters: clinical studies, animal experiments, and acupuncture points research. Recent studies have focused more on acupuncture points and their clinical applications, particularly in neuropsychiatric disorders, rather than fundamental meridian research. In addition, data mining has emerged as a new methodology in the field. Research collaboration was primarily occurring amongst investigators in South Korea and China (limited international cooperation). While interest in preclinical studies has declined, promising clinical applications continue to emerge. This review highlighted the need for broader international collaboration and integration of traditional concepts with modern research methodologies.

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

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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.

Short Communications

Benefits of Qigong: a 3-Months Online Course: Maria da Luz Rosário de Sousa, Maria Imaculada Lima Montebello, Érika Johnson; Perspect Integr Med. 2025;4(1):57-61. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.007

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Abstract PDF Supplementary Material

Background
Qigong is an ancient Chinese health practice integrating slow, mindful movements, regulated breathing, and meditative awareness to promote the circulation of vital energy, and enhance overall well-being.
Methods
A prospective, longitudinal, exploratory study was carried out to investigate the effects of Qigong on the overall quality of life following a three-month online Qigong course (n = 21). Data were collected using The World Health Organization Quality of Life Brief Version questionnaire, and supplemented with self-reported measures of pain, anxiety, and sleep quality.
Results
A 10.86% improvement in the overall quality of life (from 68.44 to 75.87; p < 0.001) was observed. Physical (p = 0.003), psychological (p = 0.004), social (p = 0.046), and environmental (p = 0.001) domains also demonstrated meaningful gains, with notable increases in energy levels, daily functioning, self-esteem, and sleep quality. Over half of the participants reported marked reductions in pain severity, and anxiety, and 54.7% experienced improvements in sleep quality (ranging from 70% to 100% of baseline values). Course adherence was high, with most participants expressing satisfaction, willingness to recommend the program, and interest in continuing Qigong practice.
Conclusion
Qigong may boost physical and mental health, reduce stress and anxiety, and improve sleep quality. To corroborate these findings, large-scale, multicenter, randomized, controlled trials are necessary.

Citations

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Acupuncture for Anxiety: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Andrew Jang, Maren Wenninger, Hyangsook Lee, Shuai Zheng
Journal of Clinical Psychology.2025;[Epub] CrossRef

Developing of an Integrative Medicine Inpatient Care Program for Breast Cancer Patients Post-Chemotherapy: Eun-Bin Ko, Jun-Bock Jang, Deok-Sang Hwang; Perspect Integr Med. 2025;4(1):51-56. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.006

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Abstract PDF Supplementary Material: Adjuvant chemotherapy for breast cancer (BC) has improved survival rates but often causes adverse effects such as nausea, vomiting, myelosuppression, and peripheral neuropathy, which can greatly impact patient quality of life. Integrative medicine (IM) provides adjunctive therapies to alleviate these toxicities and support immune function, yet existing clinical practice guidelines and pathways offer broad recommendations that may not sufficiently address the specific needs of post-chemotherapy BC patients. To address this gap, we developed an IM Inpatient Care Program framework for BC patients within one week of chemotherapy administration, drawing on the Korean Medicine Clinical Practice Guideline (KMCPG) for BC supportive care, an established clinical pathway, and additional guidelines focused on chemotherapy-related toxicities. The proposed inpatient model prioritizes systematic monitoring, early detection, and management of common chemotherapy-induced side effects such as neutropenia, peripheral neuropathy, gastrointestinal issues, and psychological distress. Key components include vital sign surveillance, targeted diagnostic tests (e.g., hematology, imaging), dietary and lifestyle recommendations, tailored herbal medicine prescriptions, acupuncture, moxibustion, and referral protocols for serious complications. The IM Inpatient Care Program aims to standardize treatment processes, enhance patient and clinician satisfaction, and reduce potential emergency department visits. By aligning evidence-based guidelines with real-world clinical insights, this model provides a structured approach to optimize BC patient care post-chemotherapy. Future efforts should involve implementing and evaluating the program in diverse clinical settings to refine its utility, measure outcomes, and potentially lower healthcare costs while improving quality of life for BC patients.

Original Articles

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

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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.

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

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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.

Optimized Protocols for the Isolation and Culture of Primary Neurons from Rat Cortex, Hippocampus, Spinal Cord, and Dorsal Root Ganglia: Ganchimeg Davaa, Do In Kim, Jennifer O. Buitrago, Jin Young Hong; Perspect Integr Med. 2025;4(1):16-27. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.003

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Abstract PDF Supplementary Material

Background
The isolation and culture of primary neurons from specific regions of the rat nervous system are fundamental techniques for investigating neuronal function, development, and pathology. These tools allow the exploration of distinct neural populations and their roles in health and disease.
Methods
Protocols were optimized for dissection, isolation, and culture of primary neurons from the rat cortex, hippocampus, spinal cord, and dorsal root ganglia. Each methodology was customized to address the unique properties of the respective tissue types, focusing on key steps to enhance neuronal yield and viability whilst minimizing contamination with non-neuronal cells. The protocols incorporate refined enzymatic dissociation techniques, mechanical trituration methods, and specialized culture conditions to support neuronal survival and maturation. Additionally, essential considerations for neuronal culture such as growth medium composition, cell density used for plating, and substrate preparation were addressed.
Results
These region-specific methodologies yielded robust and reproducible outcomes, enabling the generation of reliable in vitro models of neurons from both the central and peripheral nervous systems. The optimized procedures effectively increased neuronal viability and purity, making them suitable for a wide range of neuroscience applications.
Conclusion
This comprehensive set of protocols represents a valuable resource for researchers working in neuroscience on rats. Practical approaches to isolate and culture neurons from diverse regions of the nervous system in the rat have been described. The methodologies outlined provide a strong foundation for studying neuronal populations and their significance in various physiological and pathological contexts.

Citations

Citations to this article as recorded by

Neurons in a Dish: A Review of In Vitro Cell Models for Studying Neurogenesis
Mariana Vassal, Ana C. Cruz, Sandra Rebelo, Filipa Martins
Journal of Neurochemistry.2026;[Epub] CrossRef
Cibotii Rhizoma extract protects rat dorsal root ganglion neurons against H2O2-induced oxidative stress
Hyunseong Kim, Jin Young Hong, Changhwan Yeo, Hyun Kim, Wan-Jin Jeon, Junseon Lee, Yoon Jae Lee, Eugene Huh, In-Hyuk Ha
BMC Complementary Medicine and Therapies.2025;[Epub] CrossRef

Review Article

The Safety and Effectiveness of Electroacupuncture for Labor Pain Relief: a Systematic Review and Meta-Analysis: Hyein Jeong, Jiwon Heo, Hyunsuk Park, Kyeong Han Kim; Perspect Integr Med. 2025;4(1):6-15. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.002

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Abstract PDF Supplementary Material: Background
Labor pain is among the most intense forms of pain, significantly impacting physical and psychological well-being. Although epidural anesthesia is effective, it has side effects and limited accessibility. Electroacupuncture (EA) offers a low-risk alternative. This systematic review and meta-analysis assessed the safety and effectiveness of EA in relieving labor pain and duration.
Methods
Randomized controlled trials comparing EA with standard treatments, including epidural anesthesia, were identified through database searches up to August 2024. The primary outcome was pain reduction (assessed using the visual analog scale), and the secondary outcomes were labor duration (1^st and 2^nd stages), Apgar scores, and adverse effects.
Results
In the analysis there were 10 randomized controlled trials (involving 1,498 women in labor) included in this review. EA statistically significantly improved both the level of pain and reduced labor duration compared with those women who received standard treatments (p < 0.001). Apgar scores were assessed in 3 studies and determined that the physical condition of the delivered babies was not statistically significantly different between EA and standard treatment for labor pain. Study protocol indicated the recording of adverse effects in one of the ten studies. Adverse events in that study recorded mild localized discomfort (1.89%, n = 1).
Conclusion
EA reduced labor pain and duration, and demonstrated its potential as an alternative to the conventional approaches for managing labor pain. The limited data suggest EA is likely safe, but further research is needed to confirm its safety profile.

Editorial

Empowering Acupuncture Students Through an Education in Research: Using Case Reports to Enhance Learning and Clinical Practice: Sandro Graca, Samantha J. Allen, Harriet Lansdown, Rosa N. Schnyer, Kathleen Lumiere; Perspect Integr Med. 2025;4(1):1-5. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.001; Correction in: Perspect Integr Med 2025;4(2):125

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Abstract PDF

The current landscape of acupuncture education is marked by significant challenges including the closure of prominent schools and a decline in student enrollment. Addressing these issues requires innovative approaches that improve educational content and student engagement. Given the recognized interest in research amongst students, integration of research skills into acupuncture education is vital in the development of students into practitioners who are equipped with critical thinking. These skills enable meaningful engagement with scientific literature and facilitate the delivery of evidence-based care. Production of a case report goes beyond taking simple case histories and provides a practical bridge between theory and clinical practice by teaching students research skills (systematic data collection, detailed analysis, and critical evaluation of treatment outcomes). The work involved in case reports enhances diagnostic skills, clinical reasoning, and communication with peers and other healthcare professionals. When used in conjunction with pragmatic data sets, case reports may be used in secondary analyses that reflect real-world clinical settings in a more practical way than clinical trials providing insights into broader clinical patterns and outcomes. The integration of research-focused learning prepares students for evidence-based practice, promotes interdisciplinary communication, and supports professionalism in acupuncture through contributions to the clinical evidence base.

Citations

Citations to this article as recorded by

When the Needle Becomes the Question: Responsible Reporting of Acupuncture-Related Adverse Events
Ye-Seul Lee, Tae-Hun Kim
Perspectives on Integrative Medicine.2026; 5(1): 1. 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.

Citations

Citations to this article as recorded by

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
Effectiveness and Safety of Pharmacopuncture Therapy for Patients with Lumbar Spinal Stenosis: A Systematic Review of Randomized Controlled Trials
Do-Young Kim, Dong Jin Kim, Dong Ju Yoon, Ji-Sung Yeum, Ye Rim Yun, Ik-Jun Cho, Jin-Yeong Shin, Jaeyoung Youn, Jin Yong Choi
Journal of Acupuncture Research.2025;[Epub] CrossRef

Protocols

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; Perspect Integr Med. 2024;3(3):172-176. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.007

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Abstract PDF: Background
Traditional, complementary, and integrative medicine (TCIM) has witnessed significant growth in interest globally. Despite its popularity, TCIM research encounters numerous challenges including funding, methodological issues, and risk of bias. Preprints (scientific manuscripts openly accessible before formal peer review) present a potential solution, and understanding the characteristics and impact of TCIM preprints could offer valuable insights.
Methods
A bibliometric analysis will be conducted on all TCIM-related preprints, since inception, and posted on preprint servers with TCIM subject filters. Preprints will be sourced from servers listed in the Accelerating Science and Publication in Biology directory which allow filtering by TCIM-related categories. The preprint server and URLs, preprint server’s disciplinary scope, ownership type, screening processes, external content indexing, permanence of content, preservation of content, and comments will be extracted. The number of TCIM-related preprints yielded, and which TCIM-related term each preprint server uses will be noted. Data will be extracted from each eligible preprint: preprint server, title, DOI, preprint posted date, status of preprint, journal of final publication, final publication date, type of preprint, abstract of preprint, authors, author affiliation(s), country of corresponding author, funders, number of views, number of downloads, number of comments, number of citations, number of versions, and keywords. Descriptive statistics will be used to summarize the bibliometric characteristics, and trend analysis will identify publication patterns over time.
Conclusion
This protocol was developed for a study to identify trends in TCIM research dissemination, and contribute to a better understanding of how preprints are being used to advance the field

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

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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.

Short Communication

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; Perspect Integr Med. 2024;3(3):162-167. Published online October 23, 2024; DOI: https://doi.org/10.56986/pim.2024.10.005

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Graphical Abstract Abstract PDF: Integrative Medicine (IM), which includes therapies such as acupuncture, herbal medicine, yoga, and meditation, is gaining attention for managing chronic pain conditions. However, concerns about the quality of evidence supporting the use of these interventions persist. The 5th Annual Jaseng Academic conference 2024, in Seoul, South Korea, themed "Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions," addressed these concerns by focusing on advancements in study design, evidence synthesis, and open science practices. This conference proceeding summarizes key insights from the conference, emphasizing the role of pragmatic randomized controlled trials (pRCTs) in evaluating real-world effectiveness, and addressing the complexities involved in IM research such as sham controls. The integration of IM therapies into comprehensive pain management strategies (particularly in Korea), supported by government-backed research and policy initiatives was also discussed. Advancements in methodologies were addressed, such as bibliometric analysis, evidence mapping, and the development of clinical practice guidelines (CPGs) for integrative therapies. These methodologies offer valuable insights but face challenges due to the heterogeneity of IM interventions, and potential synergistic or antagonistic effects when combined with conventional medicine. Finally, the potential of open science to enhance transparency, reporting, and reproducibility in IM was explored, emphasizing the increased role of adherence to reporting guidelines (CONSORT and PRISMA). The future of IM research is built upon the continued efforts of refined study designs, rigorous evidence synthesis, and the integration of open science principles, for a robust and more credible evidence base.

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
Ultrasound-guided acupuncture therapy in Korea: advancing traditional practices with new technology
Sang-ho Lee, You Suk Youn, Min Chul Kim, Junghum Sun, Donghyon Ha, Tae-Hun Kim
Frontiers in Medicine.2025;[Epub] CrossRef

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.

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Healthcare.2025; 14(1): 38. 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.

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Electroacupuncture at nerve innervation zones combined with exercise rehabilitation for early-stage knee osteoarthritis in older adults: A randomized controlled trial protocol
Huang Jin-Hao, Marwa Osama, Ge Si-Yuan, Hu Miao-Miao, Shi Tian-Hui, Dong Lu, Xu Guo-Hui
European Journal of Integrative Medicine.2026; 83: 102630. CrossRef
Effects of 650 nm laser acupuncture on cartilage, bone, and skeletal muscle in osteoarthritis
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Bone Reports.2025; 26: 101864. CrossRef

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

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.

Citations

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Unlocking the potential of Shilajit in Vascular Dementia behind pathology and management - A concise review
Kousik Maparu, Shamsher Singh
Brain Disorders.2025; 19: 100244. CrossRef
Clinical studies and safety evidence for human consumption of Shilajit: a herbo-mineral compound with multifaceted health benefits
Ashif Iqubal, Abdul Qadir
International Journal of Basic & Clinical Pharmaco.2025; 14(4): 630. CrossRef

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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Graphical Abstract Abstract PDF Supplementary Material

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.

Citations

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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; 31(4): 313. 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

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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3 Citations

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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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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28 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.

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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

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

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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.

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

Protocol

Validation of a New Sham Acupuncture Needle for Double-Blind Trials: A Study Protocol: Sung Min Lim; Perspect Integr Med. 2024;3(1):57-60. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.008

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Abstract PDF

Background
To establish efficacy in acupuncture treatment, rigorous randomized controlled trials (RCT) are needed. Non-invasive sham acupuncture needles are an effective tool for practitioner/participant blinding. This study presents a protocol for the validation of a newly developed sham acupuncture needle.
Methods
A double-blind RCT will be conducted on 66 healthy adults who will be randomly assigned (using computer-generated random numbers) to either the verum (n = 33) or sham (n = 33) acupuncture needle group. The needles will be inserted at 2 acupuncture points: LI4 (upper limb) and ST36 (lower limb). The primary outcome measure is the practitioner/participants belief that they received verum or sham acupuncture. The secondary outcome measures are participant-rated sensations (penetration, pain, and de qi). Adverse events will be recorded with detailed explanations, categorizing occurrences according to related or unrelated to acupuncture. As the newly developed sham acupuncture has not been studied before, an exploratory approach has been adopted. Descriptive statistics, t test, and χ² test will be applied appropriately.
Results
This study is intended to provide a protocol for the validation of a sham acupuncture needle by using a double-blind RCT setting, and the results will hopefully contribute to the standardization of the needles used for sham acupuncture. The outcomes aim to determine the reliability of practitioner/participant blinding, participant experience of sensations, and lay groundwork for a standardized control group for clinical trials in the future. The newly developed non-invasive sham acupuncture needle may reduce bias and improve reliability in the size effect of acupuncture treatment.

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Designing an Attention Control Condition for a Randomized Controlled Trial Using TED Talks
Karen A. Nelson, Sahereh Mirzaei, Judith M. Schlaeger, Hongjin Li, Larisa Burke, Peter Cabezas, Monya Meinel, Lauren Rountree, Sofie Su, Holli A. DeVon
Western Journal of Nursing Research.2025; 47(8): 764. CrossRef
Introducing a novel sham acupuncture method for double-blind trials: A validation study
Sung Min Lim, Eunji Go, Jungsup Lee, Go Eun Lee, Chihyoung Son
Complementary Therapies in Medicine.2025; 92: 103198. CrossRef
A Protocol for the Validation of Novel Sham Acupuncture in Patients Who Have Had a Stroke
Sung Min Lim
Perspectives on Integrative Medicine.2024; 3(3): 168. CrossRef

Case Report

Complete Remission of Drug-Induced Acute Dizziness Using Eight Constitution Acupuncture and the Barbecue Maneuver: A Case Report: Younkuk Choi, Juhee Cho; Perspect Integr Med. 2024;3(1):51-56. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.007

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Abstract PDF

Dizziness, often symptomatic of underlying conditions, presents management challenges especially when dealing with drug-induced vestibular disorders. Complementary therapies like acupuncture, specifically, Eight Constitution Acupuncture (ECA), offers a potential alternative to other management therapies. A 74-year-old female, experiencing sudden dizziness from medication for back pain, underwent a detailed examination, constitutional diagnosis, and targeted acupuncture involving 26 insertions over 4 sessions. The treatment for dizziness, which focused on constitutional differences, integrated ECA and the barbecue maneuver which resulted in significant efficacy. A 50% reduction in the Numeric Rating Scale score from 10 to 5 was observed after the 1^st session. Subsequent sessions of ECA combined with the barbecue maneuver significantly reduced symptoms of dizziness and ultimately alleviated symptoms. This case underscored the potential of ECA when combined with the application of the barbecue maneuver in treating drug-induced vestibular disorders and residual benign paroxysmal positional vertigo. The ECA's constitutional approach allows for precise targeting and symptom resolution, and integrating the principles of Traditional Asian Medicine with biological mechanisms. Notably, this is the 1^st case report of the efficacy of ECA and the barbecue maneuver in addressing drug-induced vestibular disorders. A holistic approach, considering constitutional differences, can offer insights and tailored solutions to present a promising avenue for patients experiencing such conditions. Rigorous research studies are essential to validate these findings.

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Case Report: Improvement of functional dyspepsia using eight constitution acupuncture and eight constitution diet – A report of three cases
Nahyun Cho, Younkuk Choi, Heekyung Kim, Heeyoung Moon, Younbyoung Chae, Sungha Kim, Jungtae Leem
Frontiers in Medicine.2025;[Epub] CrossRef

Original Article

A Survey of the Clinical Practice of Korean Medicine for Smoking Cessation in Public Health Centers: A Web-Based Survey of Public Health Doctors of Korean Medicine: Gyoungeun Park, Jeong-Hyun Moon, Eun-Jung Kim, Byung-Kwan Seo, Yong-Hyeon Baek, Won-Suk Sung; Perspect Integr Med. 2024;3(1):45-50. Published online February 22, 2024; DOI: https://doi.org/10.56986/pim.2024.02.006

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Graphical Abstract Abstract PDF Supplementary Material: Background
In South Korea, public health centers provide smoking cessation (SC) treatments including behavioral therapy and nicotine replacement treatment. Also, public health doctors of Korean medicine (PHDKMs) are providing Korean Medicine (KM) treatments. Several studies have reported the clinical usefulness of KM treatment, but in this study, the opinion of PHDKMs was explored to examine the current KM treatments for SC.
Methods
A web-based survey (Moaform) of the treatment for SC by PHDKMs consisted of 5 main sections including clinical practice status, SC participants, KM treatments for SC, progress and prognosis, and perception of KM. The survey was emailed twice to 621 PHDKMs on April 6 to 20, 2022. The frequencies and percentages of each question were calculated.
Results
There were 28 PHDKMs who participated in the survey. Among them, over 90% of PHDKMs had treated ≤ 10 SC participants, and about 10% of PHDKMs had treated 11-20 participants. The abstinence rate was 56.8% with an average 63.2% level of satisfaction in the treatment. Typically used, and recognized as important KM treatments, were auricular acupuncture, acupuncture, education, and herbal medicine. While auricular acupuncture and education were perceived as convenient KM treatment, PHDKMs thought that SC could not be achieved with KM treatment alone and needed be combined with other treatments.
Conclusion
This survey showed the effectiveness of KM treatments with withdrawal symptoms, and treatment satisfaction of SC participants. Respondents also thought that KM treatment combined with other treatments is more effective than KM monotherapy. Based on this small study, further research would be needed.

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