Acupuncture-type interventions (such as moxibustion and acupuncture) at Bladder 67 (BL67, Zhiyin point) have been proposed to have positive effects on breech presentation. The aim of this systematic review and meta-analysis was to evaluate the effectiveness and safety of moxibustion and acupuncture in correcting breech presentation. We searched PubMed, MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Electronic Periodical Services (CEPS), and databases at ClinicalTrials.gov to identify relevant randomized controlled trials (RCTs). In this study, sixteen RCTs involving 2555 participants were included. Compared to control, moxibustion significantly increased cephalic presentation at birth (RR = 1.39; 95% CI = 1.21–1.58). Moxibustion also seemed to elicit better clinical outcomes in the Asian population (RR = 1.42; 95% CI = 1.21–1.67) than in the non-Asian population (RR = 1.20; 95% CI = 1.01–1.43). The effects of acupuncture on correcting breech presentation after sensitivity analysis were inconsistent relative to control. The effect of moxibustion plus acupuncture was synergistic for correcting breech presentation (RR = 1.53; 95% CI = 1.26–1.86) in one RCT. Our findings suggest that moxibustion therapy has positive effects on correcting breech presentation, especially in the Asian population.

Uterine fibroids (UFs) are prevalent benign tumours affecting women; they often present with symptoms such as excessive menstrual bleeding, pelvic discomfort, recurrent pregnancy loss, and infertility. High-intensity focused ultrasound (HIFU) has emerged as a non-invasive treatment option. Recent studies suggest that Chinese herbal medicines (CHMs) may enhance the efficacy of HIFU, but a comprehensive evaluation of their combined effects is lacking. To evaluate the effectiveness of CHMs combined with HIFU for UFs through a meta-analysis on randomised controlled trials (RCTs) and identify core herbal patterns that may potentiate HIFU outcomes. English and Chinese databases were searched to identify relevant studies until May 2024. The risk of bias was evaluated using the Cochrane Risk of Bias 2 tool. A meta-analysis was performed using RevMan 5.4 software. The primary outcomes were changes in UF volume and clinical efficacy; secondary outcomes were changes in uterus volume, Traditional Chinese Medicine syndrome scores, incidence of recurrences and adverse reactions. Network analysis was performed to identify core herbs. Nineteen RCTs were included. The effects of reducing UFs volumes in the CHM group were more significant than those in the control group (SMD:0.34; 95 % CI:0.44 to -0.23, p < 0.001, I² = 0 %). The clinical effectiveness rate was higher in the CHM group than with HIFU therapy alone (risk ratio: 1.13; 95 % CI: 1.08 to 1.18; p < 0.001; I² = 37 %). Core pattern analysis revealed a total of 26 single herbs and 93 commonly used herbal combinations. Among these, Curcumae Rhizoma, Sparganii Rhizoma, Astragalus membranaceus, Poria cocos, Paeonia suffruticosa, and Trionyx sinensis were the most frequently utilized herbs. This is the first meta-analysis to evaluate the clinical effectiveness of combining CHMs with HIFU for UFs, integrating both quantitative outcome and computational core herb pattern analyses to identify CHMs that may enhance the efficacy of HIFU. In addition to demonstrating superior clinical effectiveness, this study proposes a novel hypothesis: core CHMs may enhance HIFU efficacy through a dual-phase mechanism-promoting apoptosis during thermal ablation and modulating fibrotic and proliferative signaling pathways in the post-ablation phase. These findings provide an evidence-based foundation for developing integrated therapeutic strategies.

Insufficient lactation, known as hypogalactia, is an important reason for weaning. To date, no effective methods have been established to increase lactation volume. With the advantages of low cost and convenience, acupoint stimulation—defined as any stimulation applied at acupoints—is a promising option. The aim of this systematic review was to evaluate the effectiveness of acupoint stimulation for postpartum breastfeeding insufficiency. A systematic search of seven databases (PubMed, MEDLINE, Embase, Cochrane, CNKI, Airiti Library, ClinicalTrials.gov) was performed from their inception dates to September 30, 2023. Randomized trials were included. The inclusion criteria of the intervention included acupuncture, acupressure (including tuina and massage), electroacupuncture, laser stimulation, catgut embedding, and auriculotherapy. The primary outcomes were the amount of lactation and the level of prolactin. Secondary outcomes were colostrum time and adverse effects. The risks of bias were assessed using RoB 2.0. Twenty-four studies involving 3214 participants were included. When compared to the control group, the experimental group exhibited improved volume of milk production (MD = 81.30; 95% CI = 58.94–103.67) and higher prolactin levels (MD = 41.90, 95% CI = 28.57–55.22). Colostrum time was shorter in the control group ([MD = − 7.26; 95% CI = − 10.69 to − 3.83] for continuous data; [RR = 1.70; 95% CI = 1.38–2.08] for dichotomous data). Adverse effects were reported in only one trial, which included three cases of fear of acupuncture and one case of hypotension. Acupoint stimulation may have beneficial effects on postpartum breastfeeding insufficiency. However, the results should be interpreted with caution because of the presence of risks of bias and heterogeneity among studies.

Background: There has been a growing trend of combining traditional Chinese medicine and Western medicine, but the safety of co-prescribing Salvia miltiorrhiza (Danshen) and anticoagulants remains uncertain. Objectives: This study aimed to evaluate the bleeding risk following the concurrent prescribing of S. miltiorrhiza and anticoagulants in a real-world setting. Design: A self-controlled case series study was conducted. Methods: This study used the Chang Gung Research Database to identify adult patients co-prescribed oral anticoagulants and S. miltiorrhiza , and having records of bleeding events. Bleeding events included any bleeding event (gastrointestinal, intracranial, or urogenital bleeding) and major bleeding events (hemorrhages requiring hospitalization or transfusion). Exposure periods were defined as days of concurrent prescribing of S. miltiorrhiza and anticoagulants, while control periods included days of anticoagulant use without S. miltiorrhiza . Conditional Poisson regression was applied to estimate bleeding risk during exposure periods relative to control periods, and results were presented as adjusted incidence rate ratio (aIRR) and 95% confidence interval (95%CI). Results: Among 525 patients receiving both medications, 146 experienced bleeding events. The risk of any bleeding increased significantly during days 1–14 (aIRR: 3.98; 95% CI: 3.29–4.77) and days 15–28 (aIRR: 3.99; 95% CI: 3.23–4.79) after concurrent prescribing of S. miltiorrhiza and anticoagulants. Elevated risks of gastrointestinal bleeding (aIRR: 3.79; 95% CI: 2.95–4.53) and intracranial hemorrhage (aIRR: 3.59; 95% CI: 2.79–5.03) were observed within the first 14 days. Conclusion: Concurrent use of S. miltiorrhiza and anticoagulants significantly increased bleeding risk, particularly during the first 28 days of coadministration. These findings highlight the need for careful monitoring during the initial period of combined therapy.

Introduction: Sarcopenia is a medical condition predominantly associated with the aging process. Currently, the most effective approach for sarcopenia involves a combination of physical activity and nutritional supplementation. However, older individuals may face challenges engaging in physical activity due to inconvenience or limited access to consistent nutritional resources. Previous studies suggest that herbal and traditional medicine-derived interventions can enhance muscle strength in sarcopenia patients; however, its effectiveness remains unclear. This study aimed to evaluate the efficacy of herbal and traditional medicine-derived interventions in treating sarcopenia through a systematic review and meta-analysis and to identify key herbal medicines through pharmacological analysis. Methods: Following PRISMA guidelines, a comprehensive database search was conducted, yielding 11 randomized controlled trials with 781 participants. Studies were selected based on stringent criteria and assessed for methodological quality using the Risk of Bias 2.0 tool. A traditional Chinese medicine (TCM) network and data mining analysis to identify the core TCM from the enrolled trials and to investigate the potential pharmacological pathways through which they may exert their effects. Results: The analysis suggested that herbal and traditional medicine-derived interventions, particularly Bu-Zhong-Yi-Qi (BZYQ) decoction, may improve handgrip strength and appendicular skeletal muscle mass index in patients with sarcopenia, with few reported adverse effects. Network pharmacology analysis indicated that key components, such as Astragalus membranaceus, may act through multiple signaling pathways. Core genes identified, including AKT1, TNF, IL6, and FOS, showed high centrality in the interaction network, suggesting their potential relevance as therapeutic targets. Conclusion: Herbal and traditional medicine-derived interventions may have potential benefits in improving muscle strength and muscle mass in patients with sarcopenia. However, the certainty of the evidence is very low, and the findings should be interpreted with considerable caution.