Tuina, as one of the characteristic external therapies of Traditional Chinese Medicine (TCM), has been used to treat the disease caused by peripheral nerve injury (PNI) for thousands of years. An increasing number of clinical trials and animal experiments have demonstrated that tuina can improve the symptoms and promote the recovery of damaged nerves. This review focuses on the mechanistic studies of tuina in promoting the recovery of PNI, which might provide a neurobiological foundation for the effects of tuina. Although many mechanisms underlying the effects of tuina on nerve repair have been identified, there are still many unknown problems, such as the key substance or way for tuina to work, so further investigation is warranted.

Tuina can effectively alleviate ulcerative colitis-related symptoms, but the mechanism of action is unknown. The purpose of this research is to explore potential pathways for the treatment of tuina through gut microbiota and proteomics techniques. Thirty-two male BALB/c mice were divided into four groups, the control, model, mesalazine, and tuina groups. The ulcerative colitis model was established by freely drinking a 3% dextran sulphate sodium solution for 7 days. The mesalazine group and the tuina group, respectively, received 7 days of mesalazine and tuina treatment. Subsequently, their body weights, feces properties, colon length, histomorphological changes, gut microbiota, and colon proteomics were determined. Body weights, disease activity index score, colon histological scores, and microbiota diversity were restored in the tuina group. At the phylum level, Firmicutes was increased and Bacteroidota decreased. At the family level, Lachnospiraceae increased and Prevotellaceae decreased. At the genus level, the Lachnospiraceae_NK4A136_group was increased. Proteomics detected 370 differentially expressed proteins regulated by tuina, enriched to a total of 304 pathways, including biotin metabolism, Notch signaling pathway, linoleic acid metabolism, and autophagy. Tuina can effectively improve the symptoms of weight loss, fecal properties, and colon inflammation in ulcerative colitis mice and restore the gut microbiota diversity, adjusting the relative abundance of microbiota. The therapeutic effects of tuina may be achieved by modulating the signaling pathways of biotin metabolism, Notch signaling pathway, linoleic acid metabolism, and autophagy.

Inflammatory bowel disease (IBD) is a chronic inflammatory disease with a high prevalence and canceration rate. The immune disorder is one of the recognized mechanisms. Acupuncture is widely used to treat patients with IBD. In recent years, an increasing number of studies have proven the effectiveness of acupuncture in the treatment of IBD, and some progress has been made in the mechanism. In this paper, we reviewed the studies related to acupuncture for IBD and focused on the immunomodulatory mechanism. We found that acupuncture could regulate the innate and adaptive immunity of IBD patients in many ways. Acupuncture exerts innate immunomodulatory effects by regulating intestinal epithelial barrier, toll-like receptors, NLRP3 inflammasomes, oxidative stress, and endoplasmic reticulum stress and exerts adaptive immunomodulation by regulating the balance of Th17/Treg and Th1/Th2 cells. In addition, acupuncture can also regulate intestinal flora.

Inflammatory bowel disease (IBD), a chronic gastrointestinal disorder, poses significant global health challenges. Analyzing its burden across Group of Twenty (G20) nations helps identify region-specific priorities and guide health policy. This study aims to evaluate temporal trends in IBD incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across G20 countries from 1990 to 2021 and project future burdens through 2050. Data from the Global Burden of Disease 2021 Study were analyzed. Age-standardized rates (ASRs) of IBD metrics were assessed by sex, region, and sociodemographic index. Temporal trends were quantified using annual percentage change, and predictive modeling was performed using autoregressive integrated moving average, exponential smoothing, and Bayesian age–period–cohort models, validated by root mean square error, mean absolute error, and R ² statistics. Between 1990 and 2021, G20 nations experienced declining ASRs for prevalence (48.02 → 44.88/100,000) and mortality (0.60 → 0.52/100,000) but rising incidence (4.22 → 4.45/100,000) and DALYs (17.79 → 18.07/100,000). Absolute cases and deaths nearly doubled. Females had higher prevalence and disability burden, whereas males exhibited higher incidence and mortality. Canada and Germany recorded the highest DALY rates. Projections to 2050 suggest continued growth in absolute burden but declining ASRs, largely driven by population aging and epidemiologic transition. Despite reductions in standardized rates, IBD’s absolute burden continues to increase among G20 countries. Persistent sex and regional disparities highlight the need for equitable, sociodemographic index-specific prevention, and management strategies.

Background: Pediatric massage (PM) belongs to traditional Chinese medicine treatment (TCM) and is an alternative therapy for tic disorders (TD). This systematic review and network meta-analysis (NMA) was undertaken to evaluate the efficacy and safety of PM, the effectiveness of PM in conjunction with other TCM therapies for TD and to provide an evidence-based foundation for the clinical selection of the TD treatment regimens relating to traditional Chinese medicine.Methods: Eight databases were systematically searched from their inception to June, 2024 for randomized controlled trials (RCTs) of PM and its combination with other TCM therapies for TD. Two researchers screened the studies and extracted the data according to our inclusion criteria, and the bias assessment tool from the Cochrane Handbook was used to evaluate the quality of the included studies. Stata 17.0 software was used to perform NMA, and the efficacy and safety of PM and its combination with other TCM therapies were compared and ranked.Results: A total of 24 RCTs, covering 1,657 children with TD, were included in this NMA. There were 9 intervention measures, including PM, Western medicine (WM), PM + Chinese herbal medicine (CHM), PM + manual acupuncture (MA), PM + auricular acupuncture (AA), PM + Qigong therapy (QT), PM + cupping therapy (CT), PM + scraping therapy (ST), and PM + moxibustion (Mox). PM + CHM may be most effective at improving the total effective rate and decreasing YGTSS motor tics score and YGTSS vocal tics score; PM + MA may have the best performance in reducing the YGTSS total score; and simple PM may be the best at reducing the adverse reaction rate. The GRADE assessment showed that the overall response rate and the total YGTSS score were rated as low or very low quality due to the limitations of the original study, and other measures were rated as moderate quality. Therefore, these results need to be interpreted with caution and validated further.Conclusion: PM and its combination with other TCM therapies are effective and safe interventions for TD in children. More specifically, PM + CHM may be the best choice for improving clinical effectiveness and reducing YGTSS motor tics score and YGTSS vocal tics score, while PM + MA may be the most effective for decreasing YGTSS total score. However, due to the limitations of this study, these conclusions still need to be validated using additional high-quality RCTs.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024553846, PROSPERO CRD42024553846.

Objective. To study the effects of five tuina manipulations in rats with deep vein thrombosis (DVT) and to explore how to safely perform tuina in the treatment of thrombotic diseases. Methods. Seventy-two male Sprague-Dawley (SD) rats were randomly divided into the model, pointing manipulation, plucking manipulation, kneading manipulation, pushing manipulation, and pulling manipulation groups (n = 12). DVT model was established by incomplete ligation. The tuina intervention was started on the next day after modeling and applied once a day 10 times by the manipulation simulators. On the 3^rd and 10^th days after intervention, respectively, the effects of tuina on thrombosis were evaluated based on thrombus elasticity, blood coagulation, fibrinolytic function and blood rheology with the ultrasound elastography, four coagulation tests, enzyme linked immunosorbent assay (ELISA), and hemorheology tests. Results. In the pointing manipulation group, the strain rate ratio, 6-ketoprostaglandin F1α (6-Keto-PGF1α), and high shear rate were decreased, and the thromboxane B₂ (TXB₂) content was increased ( ). In the plucking manipulation group, the D-dimer and 6-Keto-PGF1α contents were increased, prothrombin time (PT) was shortened, and activated partial thromboplastin time (APTT) was activated, and the high shear rate and plasma viscosity were decreased ( ). In the kneading manipulation group, APTT was shortened, and 6-Keto-PGF1α, high shear rate, and plasma viscosity were decreased ( ). In the pushing manipulation group, the strain rate ratio, low shear rate, and high shear rate were all decreased ( ). In the pulling manipulation group, both the strain rate ratio and the low shear rate were decreased ( ). The 6-Keto-PGF1α changes on the 3^rd and 10^th days after intervention were opposite in the pushing manipulation group and the pulling manipulation group ( ). Conclusion. The pointing, pushing, and pulling manipulations seem to be safe in the early period of thrombosis, but the risk is likely to be elevated as the treatment course of intervention increases. The plucking and kneading manipulations potentially have certain risks in the treatment of DVT in rats.