Perspectives on Integrative Medicine

Protocol

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.

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

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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
A Review of Key Research and Engagement in 2025
John McDonald, Beltrán Carrillo, Judith Schlaeger, Sandro Graca
Journal of Integrative and Complementary Medicine.2026;[Epub] 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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The symptoms of common peroneal nerve (CPN) entrapment are similar to the symptoms of lumbar herniated intervertebral disc. We present the successful treatment of CPN entrapment masked by acute lumbar disc herniation. A 49-year-old man presented with low back pain and numbness in his left leg. Following admission, patient history, physical examination, and radiology findings, the patient received integrated Korean medicine (KM) treatment (acupuncture, pharmacopuncture, ultrasound-guided pharmacopuncture, moxibustion and cupping, herbal medicine, and chuna therapy) for lumbar disc herniation. Outcome measures included the numeric rating scale, the European quality of life five dimensions, and the Oswestry disability index. Symptoms persisted, and CPN compression was consequently suspected. On Day 12 of 23, in addition to KM treatment, an ultrasound-guided Shinbaro2 pharmacopuncture (4 mL) was performed on the CPN entrapment site. Significant symptom relief resulted after CPN treatment on Day 12. Improvement was particularly evident in the lower leg and ankle, areas where the pain had previously been misattributed to symptoms of lumbar disc herniation. His low back pain and radiating pain to the back of the left femur started to improve from Day 20 and were mild at discharge. This case highlights the importance of considering peripheral nerve entrapment in patients presenting with symptoms similar to lumbar disc herniation. It also suggests that combining traditional KM with modern diagnostic techniques such as ultrasonography, may be beneficial in the precise location for pharmacopuncture treatment. Further studies are recommended to validate these findings and explore the broader applicability of this approach.

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

Review Article

Proposal of a Case Reporting Draft Guideline for Pharmacopuncture: Literature Review of Pharmacopuncture Case Reports: Soohyun Jeong, Chaeyeon Son, Hyunjin Kim, Gapsik Yang, Hongmin Chu, Jungtae Leem; Perspect Integr Med. 2023;2(1):24-35. Published online February 21, 2023; DOI: https://doi.org/10.56986/pim.2023.02.004

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Graphical Abstract Abstract PDF Supplementary Material

Pharmacopuncture is a popular treatment that combines the advantages of both herbal medicine and acupuncture. However, pharmacopuncture care reporting guidelines have not yet been developed. This study aimed to propose a reporting guideline draft for pharmacopuncture case reports. Pharmacopuncture case reports were retrieved from 4 databases (KCI, RISS, ScienceON, OASIS) to analyze the items reported and their fidelity. We analyzed 5 existing reporting guidelines related to Korean medicine case reporting to identify the items to be included in the extension of pharmacopuncture reporting guidelines. From 3,684 studies, 29 case reports were included and 4 items were identified as not reported in enough detail: “direction and depth of pharmacopuncture” (89.5%); “method of manufacturing the syringe needle” (82.8%); “posture of the patient during the therapy” (75.9%); and “pharmacopuncture recipe” (69.5%). As a result of analyzing moxibustion and acupuncture clinical trial reporting guidelines, it was determined that detailed reporting guidelines on the type of pharmacopuncture, manufacturing method, and treatment method were required and we propose that a pharmacopuncture reporting guideline draft should include these details. Further investigations are warranted using the Delphi technique to reach agreement with clinical practitioners and clinical research experts.

Citations

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Safety Evaluation of Spray-Dried Curcuma longa L. Extract for Pharmacopuncture: acute toxicity and neurobehavioral assessment in zebrafish
Subhan Rullyansyah, Idha Kusumawati, Intan Safinar Ismail, Djoko Agus Purwanto, Dewi Isadiartuti, Muhammad Safwan Bin Ahamad Bustaman, Muhammad Afiq Bin Ngadni, Rizky Rafi Rahmawan, Ananda Permata Fitri, Charlyna Veronika Puspitasari Pattymahu
Journal of Pharmacopuncture.2026; 29(1): 136. CrossRef
Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
Jin Young Hong, Hyun Kim, Wan‐Jin Jeon, Changhwan Yeo, Junseon Lee, Hyunseong Kim, Yoon Jae Lee, In‐Hyuk Ha
JOR SPINE.2025;[Epub] CrossRef

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