Perspectives on Integrative Medicine

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 Report

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.

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.

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.

Review Article

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.

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.

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.

Protocol

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

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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.

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.

Citations

Citations to this article as recorded by

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

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.

Citations

Citations to this article as recorded by

Effects of 650 nm laser acupuncture on cartilage, bone, and skeletal muscle in osteoarthritis
Seung-Ho Seo, Sang-Mi Kang, Yang-Hee You, Chang-Su Na
Bone Reports.2025; 26: 101864. CrossRef

Original Article

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

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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

Citations to this article as recorded by

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

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.

Citations

Citations to this article as recorded by

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

Original Article

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

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Graphical Abstract Abstract PDF Supplementary Material

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

Citations

Citations to this article as recorded by

Sarcomatoid squamous cell carcinoma arising in a post-acupuncture keloid scar: a case report and literature review
Minwoo Park, Sug Won Kim, Jiye Kim
Archives of Craniofacial Surgery.2025; 26(4): 160. CrossRef

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