Perspectives on Integrative Medicine

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.

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: https://doi.org/

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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.

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.

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.

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.

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