Introduction: Despite the widespread use of ephedra in various forms, including food supplements and herbal prescriptions, comprehensive studies reviewing its efficacy and safety across different countries are lacking.Methods: We systematically searched 5 electronic databases and conducted a meta-analysis of 16 randomized controlled trials (RCTs) on ephedra-containing oral medications (EOMs), performing a dose–response analysis for weight loss.Results: The meta-analysis results revealed a statistically significant reduction in the body mass index (BMI) (MD: 1.5 kg/m2; 95% CI: −2.46 to −0.54) and secondary outcomes like body weight (BW) and waist circumference (WC). The dose–response analysis indicated a correlation between ephedra and weight reduction. The safety analysis showed no significant difference in adverse effects between the treatment and control groups (RR = 0.99, 95% CI = 0.80 ∼ 1.21, and p = 0.90).Discussion: In conclusion, EOMs demonstrated effectiveness in promoting weight loss, and the dose–response analysis indicated a correlation between ephedra and weight reduction. However, additional research is necessary due to the limited number of studies and inconsistent results among the assessment criteria. Moreover, if prescribed by traditional medicine physicians within the permissible daily ephedrine dosage range of 150 mg set by the Food and Drug Administration (FDA) and monitored by healthcare professionals, the risk of severe adverse events is likely to be minimal.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387895, identifier CRD42023387895.

Conventional medicine (CM) for paroxysmal atrial fibrillation (PAF) have limitations and side effects. Integrative approaches, including traditional herbal medicines like Liriope Tuber, are being explored for potential benefits, although evidence remains limited. In April 2023, a literature search was conducted across nine databases, focusing on randomized controlled trials assessing the effects of Liriope Tuber in traditional herbal medicine (LTHM) on PAF. The risk of bias was evaluated using Version 2 of the Cochrane risk-of-bias tool for randomized trials. A random-effects model was employed for the meta-analysis. A total of 43 studies with 3,743 participants were included. The meta-analysis indicated that adding LTHM to CM reduced PAF frequency (SMD = -0.99, 95 % CI = -1.40 to -0.57, I² = 88 %, N = 16, n = 1266), left atrium diameter (LAD) (MD = -2.39 mm, 95 % CI = -3.09 to -1.68), P-wave dispersion (Pd) (MD = -6.41 ms, 95 % CI = -8.44 to -4.37), high sensitive C-Reactive Protein (hs-CRP) (MD = -1.10 mg/l, 95 % CI = -1.73 to -0.47), and improved left ventricular ejection fraction (LVEF) (MD = 4.71 %, 95 % CI = 3.17 to 6.25). Thirty-four studies raised concerns about bias, with eight showing high risk. Certainty of evidence was rated as "low" for PAF frequency, LAD, Pd, hs-CRP, and LVEF. LTHM combined with CM may reduce PAF frequency. However, due to the complexity of interventions, with Liriope Tuber being only one component of the regimen, high risk of bias, substantial heterogeneity, and indirectness, interpretations should be cautious. PROSPERO (ID: CRD42023477926).

Introduction: The effectiveness and safety of acupuncture in the treatment of obesity have not been assessed. This poses a challenge for clinicians who choose to use acupuncture in the treatment of obesity, as they are unable to prioritize this approach based on outcome variables.Methods: In May 2024, a literature search of five databases was conducted. Only randomized controlled trials evaluating body weight (BW), body mass index, waist circumference (WC), and adverse events in patients with a body mass index (BMI) of 25 or higher for various acupuncture modalities were included. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Pairwise meta-analysis (PMA) and Bayesian network meta-analysis (NMA) were performed using a random effects model for quantitative synthesis.Results: Fourteen studies (n = 868) were included. The included studies evaluated the following acupuncture modalities: electroacupuncture (EA) (N = 6), laser acupuncture (LA) (N = 2), auricular acupuncture (AA) (N = 5), and manual acupuncture (MA) (N = 3). The PMA found that adding EA to usual care (UC), compared to UC alone, reduced BW (MD = 2.46, 95% CI = 1.12 to 3.80, I² = 58%, REM, N = 3, n = 157). The NMA of BW showed the following effect sizes for UC alone versus each acupuncture modality combined with UC: LA (MD = 2.09, 95% CI = 0.04 to 3.86), EA (MD = 2.04, 95% CI = 0.88 to 3.50), AA (MD = 1.69, 95% CI = −0.11 to 3.58), and MA (MD = 1.02, 95% CI = −0.82 to 2.94). The probability of each modality being the optimal treatment was evaluated using the surface under the cumulative ranking curve. EA was the most efficacious for BW and BMI, while LA was the most efficacious for WC.Discussion: EA and LA can effectively complement clinical obesity management. The number of included studies was limited, and publication bias may have occurred, necessitating a cautious interpretation of the results. Furthermore, most studies lasted between six and 12 weeks. Future clinical studies of acupuncture for obesity should include longer follow-up periods.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387788, identifier CRD42023387788.

Background: South Korea is anticipated to enter a super-aged society by 2025, necessitating a focus on healthy aging. In Korean medicine (KM), aging and disease susceptibility are individual specific, emphasizing personalized treatments, and many Korean local governments have integrated KM services for elderly people into the public sector. However, there is a notable absence of research incorporating KM to treat older adults. Aim: The proposed study aims to examine the comprehensive health profiles of individuals entering old age in rural and urban areas and explore the significant correlations between healthy aging and four key factors: biological, psychological, social, and KM-based phenotype factors. It will also establish a database and blood biobank, serving as a platform for future research to develop a traditional KM-based healthy aging model. Methods: A multiple randomized controlled trial design will be adopted in this prospective, multicenter cohort study for the clinical investigation of the markers associated with KM-based healthy aging. The aim is to recruit 1,000 participants who are entering old age from both urban and rural settings for this study, and recruitment began in August 2023 with follow-up surveys planned at one-year intervals. Comprehensive health profiles, including biological, psychological, social, and KM-based phenotype factors, will be developed through the creation of a database, a blood biobank, and multi-omics data. Results: In the baseline phase of this study, we will focus on identifying markers for KM-based phenotypes and examining how these phenotypes relate to aging and associated diseases. In the next phase, we will implement interventions tailored to KM-based phenotypes to verify the effects of KM on healthy aging. Ultimately, we intend to develop a KM-based integrated health management model, with further substudies aiming to explore factors related to healthy aging. This protocol was approved by the institutional review board of Wonkwang University Korean Medicine Hospital, Iksan, Republic of Korea (approval number: WKUIOMH-IRB-2023-05) on August 16, 2023 and Jangheung Integrative Medical Hospital (approval number: WKUJIM-202307-001) on August 21, 2023. Recruitment started on August 16, 2023. Conclusion: The anticipated results of our study aim to establish personalized preventive and therapeutic interventions for individuals entering old age. Additionally, we seek to offer an KM-based integrated health management model that incorporates comprehensive diagnosis and an integrative medical treatment strategy for healthy aging. Trial Registration: Clinical Research Information Service: KCT0008863 (registered on October 11, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/25718).

Introduction: Firefighters, compared to other occupational groups, are exposed more frequently in their working environment not only to physical issues, such as musculoskeletal disease, respiratory disease, and burns but also to mental health issues, such as PTSD and depression. Specifically, Korean firefighters experience significantly higher rates of work-related injuries compared to those in other countries. Recent statistics from the Korea National Fire Agency indicate a steady increase in the number of firefighting work-related injuries. However, there is a shortage of measures in place to address these issues. This study aims to investigate the health needs, overall healthcare usage, and unmet needs of firefighters in Korea. We also aim to investigate, through in-depth interviews, perceptions and hindering factors for integrative medicine approaches to fulfilling unmet needs.Method: This study was conducted in accordance with the consolidated criteria for reporting qualitative research. Convenience and snowball sampling methods will be used to recruit firefighters to participate in the study, and interviews will be conducted using a semi-structured interview guide. The data will be analyzed in four stages using the qualitative analysis method of Krippendorff.Discussion: In this study, we examine the state of health issues and healthcare usage among Korean firefighters and investigate their perceptions of and needs for integrative medicine. In this way, we aim to explore how integrative medicine and Korean medicine approaches could improve and assist healthcare services for firefighters. Furthermore, our findings will provide policymakers and healthcare providers with the necessary basic information to develop integrative medicine systems suited to firefighters.

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.