Traditional Chinese Medicine for Anxiety

Traditional Chinese Medicine (TCM) has been explored as a potential intervention for anxiety in several clinical trials and randomized controlled trials (RCTs). These studies investigate the efficacy and safety of various TCM modalities, including herbal formulas, acupuncture, and mind-body practices, in managing anxiety symptoms. The growing interest in TCM for anxiety reflects a need for diverse and potentially complementary approaches to address this prevalent mental health condition.

Protocols Studied in Research

[1] Electroacupuncture (EA) for insomnia in patients with depression. (Cited by: 25) (pmid: 35797047)

• Protocol: A 32-week, randomized, sham-controlled trial (8-week intervention, 24-week follow-up) involving 270 patients with insomnia and depression. Participants received EA, sham acupuncture, or standard care. EA involved 3 sessions per week for 8 weeks.
• Outcome: EA significantly improved sleep quality (PSQI) compared to sham acupuncture and control groups at 8 weeks, and this improvement was sustained at 32 weeks. EA also improved depression and anxiety scores. No serious adverse events were reported.

[2] Acupuncture treatment for primary insomnia. (Cited by: 82) (pmid: 28899535)

• Protocol: A single-blinded, randomized controlled trial compared acupuncture to sham acupuncture in 72 patients with primary insomnia. Treatment occurred three times weekly for four weeks, with assessments using sleep monitors and questionnaires every two weeks for eight weeks.
• Outcome: Acupuncture was significantly more effective than sham acupuncture in improving insomnia severity, sleep efficiency, total sleep time, and depression scores. Improvements in sleep awakenings and anxiety scores were also observed after the treatment period.

[3] Real and sham acupuncture for comorbid perimenopausal depression and insomnia. (Cited by: 8) (pmid: 36815166)

• Protocol: A patient-assessor-blinded, randomized, sham-controlled trial of 70 women with perimenopausal depression and insomnia receiving 17 acupuncture sessions over 8 weeks. Outcomes measured included depression and sleep quality scores.
• Outcome: Acupuncture showed a statistically significant short-term improvement in sleep quality but not depression, compared to sham. No long-term benefits were observed at 16 weeks. Treatment was safe and well-tolerated.

[4] Active acupuncture versus sham acupuncture for chemotherapy-induced insomnia in breast cancer patients. (Cited by: 9) (pmid: 37101228)

• Protocol: A blinded, randomized, sham-controlled trial involving 138 breast cancer patients with insomnia. Participants received 15 sessions of either active or sham acupuncture over 18 weeks, followed by 24 weeks of follow-up. Primary outcome was Insomnia Severity Index (ISI).
• Outcome: Active acupuncture did not significantly reduce ISI scores compared to sham at 6 weeks. However, it showed better short-term and long-term improvements in sleep parameters, anxiety, depression, quality of life, and led to a significantly higher rate of sleeping medication cessation.

[5] Verum and sham acupuncture for insomnia after ischemic stroke. (Cited by: 6) (pmid: 35317665)

• Protocol: A blinded, randomized controlled trial of 144 stroke patients with insomnia (DSM-5 criteria) received either verum or sham acupuncture (3 sessions/week for 4 weeks). Outcomes were assessed using various sleep scales and actigraphy.
• Outcome: Verum acupuncture significantly improved sleep quality (ISI, PSQI, actigraphy), quality of life (SSQoL), and reduced depression (HADS) compared to sham acupuncture, with mild and comparable adverse events.

[6] Acupuncture for Postprandial Distress Syndrome (PDS) (Cited by: 44) (pmid: 32422066)

• Protocol: A multicenter, randomized clinical trial compared acupuncture vs. sham acupuncture in 278 Chinese adults with PDS (Rome IV criteria). Participants received 12 sessions over 4 weeks.
• Outcome: Acupuncture significantly improved response rate and elimination of PDS cardinal symptoms compared to sham acupuncture, with sustained effects at 12-week follow-up. No serious adverse events were reported.

[7] Acupuncture for Temporomandibular Disorders (TMD) (Cited by: 0) (pmid: 38710498)

• Protocol: A randomized controlled trial (RCT) assigned 60 TMD patients to either real or sham acupuncture. Participants received three weekly sessions for four weeks.
• Outcome: Acupuncture significantly reduced pain intensity, improved jaw function, and lessened psychological distress compared to sham acupuncture at both 4 and 8 weeks post-treatment. Effects were sustained at 8 weeks.

[8] Tuina therapy combined with Yijinjing exercise for nonspecific chronic neck pain. (Cited by: 18) (pmid: 36512354)

• Protocol: A 12-week randomized clinical trial (8 weeks intervention, 4 weeks follow-up) compared tuina alone vs. tuina plus Yijinjing exercise in 102 participants with chronic neck pain. Both groups received 24 sessions of tuina over 8 weeks; the combined group also performed Yijinjing 3 times weekly.
• Outcome: Tuina combined with Yijinjing was significantly more effective than tuina alone in reducing pain, improving neck function, and lowering anxiety at 8 and 12 weeks. The combined approach is recommended for managing nonspecific chronic neck pain.

[9] Real and sham acupuncture for Insomnia Disorder (ID). (Cited by: 0) (pmid: 39169368)

• Protocol: A randomized controlled trial with 60 ID patients (real vs. sham acupuncture) and 30 healthy controls. Participants underwent fMRI scans before and after 4 weeks of acupuncture treatment. Clinical measures (anxiety, depression, sleep quality) were also collected.
• Outcome: Real acupuncture modulated resting-state functional connectivity within the emotional network in ID patients, particularly in the anterior cingulate cortex, hippocampus, and amygdala. These changes correlated with improvements in anxiety and sleep efficiency.

[10] Mindfulness-based intervention (MBI) for hypertension patients with depression and/or anxiety. (Cited by: 1) (pmid: 38698436)

• Protocol: A 10-week randomized controlled trial (RCT) comparing MBI plus hypertension health education (intervention group) to hypertension health education alone (control group) in 60 hypertensive patients with depression and/or anxiety.
• Outcome: MBI significantly reduced depression and anxiety symptoms, systolic blood pressure, and improved self-efficacy and awareness of physical and mental health compared to the control group. The intervention provided modest but significant relief.

[11] Simplified Tai Chi plus routine exercise for mild to moderate Parkinson's Disease symptoms. (Cited by: 23) (pmid: 31665879)

• Protocol: A 12-week randomized controlled trial comparing simplified Tai Chi plus routine exercise to routine exercise alone in 41 Parkinson's disease patients. Motor and non-motor symptoms were assessed.
• Outcome: Tai Chi plus routine exercise showed improvements in motor and non-motor symptoms, significantly outperforming routine exercise alone only in sleep quality and cognitive function.

[12] Predictive nursing interventions for pressure ulcers in elderly bedridden patients. (Cited by: 1) (pmid: 38453139)

• Protocol: A randomized controlled trial (RCT) involving 120 elderly bedridden patients. Participants were randomly assigned to receive either conventional nursing care (control) or predictive nursing interventions (observation group).
• Outcome: Predictive nursing interventions significantly reduced pressure ulcer incidence, improved Braden scores, delayed pressure ulcer onset, lowered anxiety and depression scores, and increased nursing satisfaction compared to conventional care.

[13] TCM combined group psychotherapy for psychological distress and gut microbiome regulation in colorectal cancer survivors. (Cited by: 1) (pmid: 37964024)

• Protocol: A single-arm phase I clinical trial (n=38) of a 6-week online intervention involving TCM, group psychotherapy, lifestyle coaching, self-acupressure, and mindfulness for stage I-III colorectal cancer survivors.
• Outcome: The intervention significantly reduced anxiety, depression, and fear of recurrence. Certain gut bacteria abundances increased, suggesting a potential brain-gut axis effect. A phase II RCT is warranted.

[14] Traditional Chinese Medicine (TCM) with and without chemotherapy for advanced gastric cancer. (Cited by: 0) (pmid: 38743886)

• Protocol: A randomized, double-blind, controlled trial of 102 advanced gastric cancer patients at Cangzhou Central Hospital. Patients were randomly assigned to receive TCM alone or TCM plus chemotherapy.
• Outcome: The combination of TCM and chemotherapy showed significantly better clinical efficacy, improved tumor marker levels, reduced anxiety and depression, fewer adverse reactions compared to TCM alone in patients with advanced gastric cancer.

[15] Pulsed field ablation (PFA) and radiofrequency catheter ablation (RFCA) for paroxysmal supraventricular tachycardia (PSVT), assessing quality of life, anxiety, and depression. (Cited by: 0) (pmid: 38402192)

• Protocol: A single-center, randomized, single-blind trial comparing PFA and RFCA in 50 PSVT patients. Participants completed SF-36 and HADS questionnaires at baseline, post-procedure, and 3 months post-procedure.
• Outcome: PFA showed significantly better short-term improvements in physiological function and general health compared to RFCA. Both PFA and RFCA improved quality of life, anxiety, and depression scores at 3 months post-procedure.

[16] Piwei Peiyuan Prescription for chronic atrophic gastritis (CAG). (Cited by: 1) (pmid: 38728508)

• Protocol: A multicenter, double-blind, randomized controlled trial comparing Piwei Peiyuan Prescription to a placebo in 120 CAG patients over 12 weeks. Participants were randomly assigned to receive either the prescription or placebo, plus a respective placebo or active control.
• Outcome: Piwei Peiyuan Prescription demonstrated superior efficacy in reducing CAG severity (atrophy, intestinal metaplasia) and improving TCM symptom scores compared to the control group. The intervention was deemed safe.

[17] Traditional Chinese Medicine-based rehabilitation nursing combined with scalp acupuncture (TCMRN + SA) for negative emotions and quality of life in stroke patients. (Cited by: 1) (pmid: 36316939)

• Protocol: A randomized controlled trial (RCT) of 102 stroke patients. Patients were randomly assigned to receive either TCMRN alone (control) or TCMRN + SA (observation group). Outcomes were measured using several scales before and after the intervention.
• Outcome: TCMRN + SA significantly improved negative emotions (depression, anxiety, sleep quality) and quality of life (activities of daily living) in stroke patients compared to TCMRN alone. The improvement in sleep quality was also significantly higher in the TCMRN + SA group.

[18] Traditional Chinese Medicine (TCM) syndrome differentiation for pneumoconiosis. (Cited by: 3) (pmid: 35451681)

• Protocol: A 24-week, double-blind, randomized, placebo-controlled trial with 96 pneumoconiosis patients. The treatment group received TCM; the control group received a placebo. Symptomatic treatment was given to both groups.
• Outcome: TCM treatment significantly improved six-minute walk distance, St. George Respiratory Questionnaire score, and other measures of dyspnea, quality of life, and symptom severity compared to placebo, with no serious adverse events.

[19] Bushen Huoxue formula (BSHXF) plus celecoxib for lower back pain (LBP) from lumbar disc herniation (LDH). (Cited by: 1) (pmid: 38363892)

• Protocol: A randomized controlled trial (RCT) comparing BSHXF plus celecoxib to celecoxib plus placebo in 206 patients with LBP from LDH. Treatment lasted 2 weeks, with assessments at baseline, 2, 4, and 8 weeks post-treatment.
• Outcome: BSHXF significantly improved pain (VAS), disability (ODI, RMDQ), function (TUGT, Trunk ROM) compared to the control group at all follow-up points. No significant difference in anxiety/depression (HADS) was observed.

[20] Chaihu-Shugan-San (CSS), a traditional Chinese medicine, for Functional Dyspepsia (FD). (Cited by: 0) (pmid: 38151181)

• Protocol: A randomized, double-blind, placebo-controlled trial involving 94 FD patients (Rome IV criteria) who received either CSS or placebo for four weeks. Gut microbiota analysis was conducted in a subset of participants.
• Outcome: CSS significantly improved dyspepsia symptoms, gastric emptying rate, anxiety, depression, and quality of life compared to placebo. CSS also modulated the gut microbiota in FD patients.

[21] Catgut-embedding acupuncture for functional anorectal pain (FAP). (Cited by: 0) (pmid: 37933076)

• Protocol: A randomized controlled trial comparing catgut-embedding acupuncture to sham acupuncture in 71 FAP patients. Treatment involved two sessions per month for two months. Outcomes measured included pain scores, anal incontinence, and quality of life.
• Outcome: Catgut-embedding acupuncture showed significantly greater improvement in pain, quality of life, and other measures compared to sham acupuncture (p < .001 for total effective rate). No adverse effects were reported.

[22] Long-snake-like moxibustion for Chronic Fatigue Syndrome (CFS). (Cited by: 2) (pmid: 37400824)

• Protocol: A randomized controlled trial comparing 60-minute vs. 30-minute sessions of long-snake-like moxibustion, thrice weekly for four weeks, in 60 female CFS patients. Infrared imaging (TTM) was used to assess thermal changes.
• Outcome: Longer (60-minute) moxibustion sessions showed significantly greater improvement in CFS symptoms (Fatigue Scale-14, Spleen-Kidney Yang Deficiency scale) compared to shorter (30-minute) sessions. Improvements correlated with thermal changes measured by TTM.

[23] Shugan granule for Mixed Anxiety-Depressive Disorder (MADD). (Cited by: 0) (pmid: 35085742)

• Protocol: A double-blind, placebo-controlled, multicenter randomized controlled trial (RCT) with 400 MADD patients randomized 1:1 to Shugan granule or placebo for 8 weeks. Efficacy was assessed using multiple scales.
• Outcome: Shugan granule demonstrated significantly greater efficacy than placebo in reducing MADD symptoms, as measured by various scales, with a similar safety profile.

[24] Electroacupuncture (EAG) for dry eye (DE). (Cited by: 1) (pmid: 36245315)

• Protocol: A randomized controlled trial comparing EAG (three times weekly) to artificial tears (four times daily) in 84 DE patients over 4 weeks, with assessments at baseline, 4 weeks, and 8 weeks.
• Outcome: Electroacupuncture demonstrated superior efficacy in improving tear film stability (NIBUT, TMH) and dry eye symptoms (OSDI, CFS) compared to artificial tears. Improvements in quality of life (SF-36) were also observed.

[25] Qilong capsule (QLC) combined with conventional treatment (CT) for ischemic stroke (IS) with Qi deficiency and blood stasis syndrome. (Cited by: 1) (pmid: 35780589)

• Protocol: A prospective, multicenter, non-randomized controlled trial in 7 Chinese hospitals comparing QLC + CT to CT alone in 2302 patients (35-80 years old) with IS and the specified syndrome. Treatment lasted 12 weeks, with follow-ups at 12 and 24 weeks. Propensity score matching was used.
• Outcome: QLC combined with CT showed significantly better improvement in mRS, NIHSS, Barthel Index scores, and reduction in Qi deficiency and blood stasis syndrome scores compared to CT alone at 24 weeks. No serious adverse reactions were reported. Further RCTs are needed for confirmation.

[26] Improved Gengnianchun (I-GNC) herbal formula for menopausal symptoms (hot flushes, depression, anxiety, sleep quality) in Chinese peri- and postmenopausal women. (Cited by: 6) (pmid: 32379216)

• Protocol: A 12-week, randomized, single-blind, placebo-controlled trial involving 98 peri- and postmenopausal women with high Kupperman Index scores. Participants received either I-GNC or placebo. Outcomes were assessed at 4-week intervals.
• Outcome: I-GNC significantly reduced hot flush frequency, improved KMI, Hamilton Depression, and Hamilton Anxiety scores compared to placebo. No significant effect on sleep quality or hormone levels was observed. I-GNC was deemed safe and well-tolerated.

[27] Tai Chi Chuan combined with 1-Hz rTMS for sleep disorders and mild cognitive impairment (MCI) in older adults. (Cited by: 0) (pmid: 39792383)

• Protocol: A sham-controlled randomized clinical trial (RCT) in China involving 110 older adults (60-75 years) with sleep disorders and MCI. Participants received 30 sessions of Tai Chi and either 1-Hz rTMS or sham rTMS for 6 weeks.
• Outcome: Combined Tai Chi and 1-Hz rTMS significantly improved sleep quality (PSQI) and cognitive function (MoCA) compared to Tai Chi with sham rTMS, with effects sustained at 12-week follow-up. The intervention was well-tolerated.

[28] Piano light music intervention for anxiety, pain, and satisfaction during colonoscopy. (Cited by: 1) (pmid: 36595974)

• Protocol: A randomized, single-blind controlled trial with 216 patients (112 music, 104 control) compared outcomes with and without piano music played during colonoscopy.
• Outcome: Piano music significantly reduced post-colonoscopy anxiety and procedural difficulty, and improved patient satisfaction with pain management and overall experience, without adverse effects. Patients were significantly more likely to request music in future procedures.

[29] King's Goal Attainment Theory-based online teach-back program for newly diagnosed Type 2 Diabetes. (Cited by: 0) (pmid: 39481094)

• Protocol: A randomized controlled trial (RCT) comparing standard care to an online teach-back program incorporating King's Goal Attainment Theory and an "Internet + Nursing" platform in 120 Chinese patients with newly diagnosed Type 2 Diabetes over 24 weeks.
• Outcome: The online intervention significantly improved glycemic control (lowered fasting plasma glucose, 2-hour postprandial glucose, and HbA1c) and reduced hypoglycemia-related anxiety and alexithymia compared to standard care.

[30] Transcutaneous electrical acupoint stimulation (TEAS) for postoperative pain and adverse symptoms after oocyte retrieval. (Cited by: 0) (pmid: 38310025)

• Protocol: A randomized controlled trial of 128 patients received either TEAS or a sham treatment for 30 minutes, starting 30 minutes post-oocyte retrieval.
• Outcome: TEAS significantly reduced postoperative pain (VAS scores, McGill, PRI, PPI) at 60 and 90 minutes post-procedure and reduced adverse symptoms compared to the control group. No significant difference in anxiety or nervousness was observed.

[31] Bushen Tiaogan formula (BSTG) plus Traditional Chinese Medicine-based Psychotherapy (TBP) for perimenopausal depression (PMD). (Cited by: 6) (pmid: 31513088)

• Protocol: A randomized, placebo-controlled trial in 307 Chinese women with PMD. Participants received either BSTG + TBP or placebo + TBP for 8 weeks, followed by 4 weeks of follow-up.
• Outcome: BSTG plus TBP was significantly more effective than placebo plus TBP in reducing PMD symptoms, improving hormone levels (FSH, HDL), and lipid profiles (triglycerides). No serious adverse events were reported.

[32] Active vs. placebo acupuncture for insomnia and mood disorders. (Cited by: 19) (pmid: 32167794)

• Protocol: A randomized controlled trial (RCT) of 90 insomnia patients in Chengdu, China. Participants received either active or placebo acupuncture using the Park sham device for 2 weeks, followed by a 1-month follow-up.
• Outcome: Active acupuncture significantly improved insomnia symptoms and mood (reduced PSQI, SAS, and SDS scores) compared to placebo acupuncture, with effects sustained for at least 6 weeks. The difference was statistically significant at p<.1 for most outcomes.

[33] Western-based art music therapy (WAMT) and Five Elements Music Therapy (FEMT) for psychological well-being (stress, anxiety, depression). (Cited by: 2) (pmid: 36424267)

• Protocol: A pre-post randomized controlled trial with 35 participants (23 Canadian, 12 Chinese) randomly assigned to WAMT (n=15) or FEMT (n=20) groups. Participants received four weeks of music therapy.
• Outcome: Both WAMT and FEMT significantly reduced self-rated stress in both cultural groups. FEMT also significantly reduced anxiety and depression scores, but only in the FEMT group. The study demonstrates the feasibility and effectiveness of FEMT with non-Chinese participants.

[34] Jia Wei Gui Pi Tang for Behavioural and Psychological Symptoms of Dementia (BPSD) in Alzheimer's Disease patients. (Cited by: 0) (pmid: 37005070)

• Protocol: A multicenter, randomized, observer-blind controlled trial compared Jia Wei Gui Pi Tang to a control group (no TCM) in AD patients. BPSD and positive emotions were assessed using NPI-NH and DEI, respectively.
• Outcome: Jia Wei Gui Pi Tang significantly improved BPSD scores (NPI-NH) and increased positive emotions (DEI) compared to the control group. Improvements were statistically significant within the treatment group.

[35] 2 Hz continuous wave and 2 Hz/100 Hz dilatational wave electroacupuncture (EA) for Polycystic Ovary Syndrome (PCOS) with abdominal obesity. (Cited by: 0) (pmid: 38146250)

• Protocol: A randomized controlled trial comparing two EA frequencies (2 Hz continuous and 2 Hz/100 Hz dilatational wave) in 58 PCOS patients with abdominal obesity over 12 weeks. Treatment involved acupuncture at specific points.
• Outcome: Both EA frequencies improved ovulation and reduced weight/BMI. The 2 Hz/100 Hz dilatational wave EA showed superior waist circumference reduction, decreased AMH, increased SHBG, and improved certain PCOS symptoms (acne, fatigue, dysmenorrhea).

[36] Guizhi Fuling Wan (GFW), a Traditional Chinese Medicine (TCM) formulation, for primary dysmenorrhea (PD) with heat-burning blood-stasis syndrome. (Cited by: 2) (pmid: 36746293)

• Protocol: A randomized, double-blinded, placebo-controlled trial with 121 participants receiving GFW or placebo twice daily for three menstrual cycles, followed by a 3-month follow-up. Pain intensity (VAS), menstrual symptoms (CMSS), anxiety (SAS), depression (SDS), and TCM syndrome scores were assessed.
• Outcome: GFW significantly reduced pain intensity, menstrual symptoms, and anxiety compared to placebo, with no significant difference in depression scores and no serious adverse events.

[37] Weighted blanket intervention for insomnia in adults. (Cited by: 0) (pmid: 39501163)

• Protocol: A pilot randomized controlled trial (RCT) in three Chinese hospitals compared weighted blankets to normal blankets in 102 adults with insomnia over one month. Participants were assessed using PSQI, ISI, and actigraphy.
• Outcome: Weighted blankets significantly improved sleep quality (PSQI), daytime sleepiness, stress, anxiety, fatigue, and bodily pain compared to normal blankets. Actigraphy showed a trend towards fewer awakenings in the weighted blanket group, although not statistically significant. The intervention was deemed safe.

[38] Baduanjin exercise for cognitive function and cancer-related symptoms in breast cancer patients undergoing chemotherapy. (Cited by: 14) (pmid: 35416502)

• Protocol: A randomized controlled trial (RCT) assigned 70 breast cancer patients receiving chemotherapy to either a Baduanjin exercise group (30 minutes, 5 times/week for 3 months) or a control group. Outcomes were assessed at baseline and at 4, 8, and 12 weeks.
• Outcome: Baduanjin exercise significantly improved subjective cognitive function, reduced fatigue and anxiety, and enhanced quality of life compared to the control group. Improvements in cognition were mediated by reduced fatigue and improved anxiety.

[39] Olfactory training with aromatic Traditional Chinese Medicine (TCM) or conventional aromatics for SARS-CoV-2 induced olfactory dysfunction. (Cited by: 0) (pmid: 39404183)

• Protocol: 172 patients with SARS-CoV-2 olfactory dysfunction were randomized into two groups receiving 24 weeks of olfactory training with either TCM aromatics (ginger, etc.) or conventional aromatics (rose, mint, etc.). Olfactory function was assessed using the Sniffin' Sticks test at multiple time points.
• Outcome: Both TCM and conventional aromatic olfactory training improved odor discrimination and identification after 3 and 6 months, with no significant difference between groups. The TCM group also showed improved sleep and anxiety scores. Odor detection threshold did not improve in either group.

[40] Electroacupuncture (EA) for discomfort during gastroscopy. (Cited by: 0) (pmid: 36858243)

• Protocol: A single-center, patient-assessor blind, randomized controlled trial comparing EA to sham acupuncture (SA) in 60 patients undergoing gastroscopy. EA was administered at specific acupoints for 30 minutes pre-procedure.
• Outcome: EA significantly reduced post-gastroscopy discomfort (nausea, throat discomfort, agitation) and anxiety compared to SA, as measured by VAS scores and STAI-S6. No serious adverse events were reported.

Research Interpretation: Summary and Conclusion

Numerous randomized controlled trials (RCTs) and other study designs investigated various Traditional Chinese Medicine (TCM) interventions for anxiety, employing diverse protocols including acupuncture (with variations in style and frequency), tuina, Tai Chi, herbal remedies (e.g., Shugan granule, Piwei Peiyuan Prescription, I-GNC, CSS, GFW), and combined approaches. Consistent findings across multiple studies demonstrate that several TCM interventions significantly reduced anxiety levels in diverse patient populations, including those with insomnia, chronic pain, cancer, and other conditions. While some studies showed sustained benefits at longer follow-up periods, others reported short-term improvements. Several studies indicated improvements in sleep quality, often correlated with anxiety reduction. Variations existed in the specific TCM modalities used and patient populations studied, reflecting the multifaceted nature of TCM and its potential applications. Overall, the evidence suggests that several TCM approaches hold promise for anxiety management, though further high-quality RCTs with larger sample sizes and standardized outcome measures are necessary to solidify these findings.

Publications

[1] Yin X; Li W; Liang T; Lu B; Yue H; Li S; Zhong VW; Zhang W; Li X; Zhou S; Mi Y; Wu H; Xu S (2022). Effect of Electroacupuncture on Insomnia in Patients With Depression: A Randomized Clinical Trial JAMA network open 5 (7) :e2220563.

[2] Yin X; Gou M; Xu J; Dong B; Yin P; Masquelin F; Wu J; Lao L; Xu S (2017). Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial Sleep medicine 37 :193-200.

[3] Zhao FY; Zheng Z; Fu QQ; Conduit R; Xu H; Wang HR; Huang YL; Jiang T; Zhang WJ; Kennedy GA (2023). Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial Frontiers in public health 11 :1120567.

[4] Zhang J; Qin Z; So TH; Chang TY; Yang S; Chen H; Yeung WF; Chung KF; Chan PY; Huang Y; Xu S; Chiang CY; Lao L; Zhang ZJ (2023). Acupuncture for chemotherapy-associated insomnia in breast cancer patients: an assessor-participant blinded, randomized, sham-controlled trial Breast cancer research : BCR 25 (1) :49.

[5] Cao Y; Yan YJ; Xu JY; Liwayiding A; Liu YP; Yin X; Lao LX; Zhang ZJ; Xu SF (2022). Acupuncture for insomnia after ischemic stroke: an assessor-participant blinded, randomized controlled trial Acupuncture in medicine : journal of the British Medical Acupuncture Society 40 (5) :443-452.

[6] Yang JW; Wang LQ; Zou X; Yan SY; Wang Y; Zhao JJ; Tu JF; Wang J; Shi GX; Hu H; Zhou W; Du Y; Liu CZ (2020). Effect of Acupuncture for Postprandial Distress Syndrome: A Randomized Clinical Trial Annals of internal medicine 172 (12) :777-785.

[7] Liu L; Chen Q; Lyu T; Zhao L; Miao Q; Liu Y; Nie L; Fu F; Li S; Zeng C; Zhang Y; Peng P; Wang W; Lin Y; Li B (2024). Effect of acupuncture for temporomandibular disorders: a randomized clinical trial QJM : monthly journal of the Association of Physicians 117 (9) :647-656.

[8] Cheng ZJ; Zhang SP; Gu YJ; Chen ZY; Xie FF; Guan C; Fang M; Yao F (2022). Effectiveness of Tuina Therapy Combined With Yijinjing Exercise in the Treatment of Nonspecific Chronic Neck Pain: A Randomized Clinical Trial JAMA network open 5 (12) :e2246538.

[9] Jiang TF; Chen ZY; Liu J; Yin XJ; Tan ZJ; Wang GL; Li B; Guo J (2024). Acupuncture modulates emotional network resting-state functional connectivity in patients with insomnia disorder: a randomized controlled trial and fMRI study BMC complementary medicine and therapies 24 (1) :311.

[10] Zhang H; Zhang X; Jiang X; Dai R; Zhao N; Pan W; Guo J; Fan J; Bao S (2024). Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial Trials 25 (1) :299.

[11] Zhu M; Zhang Y; Pan J; Fu C; Wang Y (2020). Effect of simplified Tai Chi exercise on relieving symptoms of patients with mild to moderate Parkinson's disease The Journal of sports medicine and physical fitness 60 (2) :282-288.

[12] Deng GL; Lei YL; Tan H; Geng BC; Liu Z (2024). Effects of predictive nursing interventions on pressure ulcer in elderly bedridden patients International wound journal 21 (3) :e14690.

[13] Sun L; Pang Y; Wang Z; Liu J; Peng R; Yan Y; Yang Y; Tang L (2023). Effect of traditional Chinese medicine combined group psychotherapy on psychological distress management and gut micro-biome regulation for colorectal cancer survivors: a single-arm phase I clinical trial Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 31 (12) :698.

[14] Shi L; Geng X; Wang Z; Wang H; Zhang Y (2024). Chinese Medicine's Effects Against Advanced Gastric Cancer: A Single-center, Randomized, Double-blind, Controlled Clinical Trial Alternative therapies in health and medicine 30 (12) :164-169.

[15] Du Y; Ma S; Yue P; Xu Y; Wen Y; Ji M; He L; Liao D (2024). Comparing the effects of pulsed and radiofrequency catheter ablation on quality of life, anxiety, and depression of patients with paroxysmal supraventricular tachycardia: a single-center, randomized, single-blind, standard-controlled trial Trials 25 (1) :146.

[16] Zhang Y; Yang Q; Song B; Tang W; Yu F; Chen H; Ge P; Fang X; Pei B; Sun Q; Li X (2024). Efficacy and safety of Piwei Peiyuan Prescription in the treatment of chronic atrophic gastritis: A multicenter, double-blind, double-simulated, randomized, controlled clinical trial Medicine 103 (19) :e37981.

[17] Xie J; Li J; Sun Q; Cai J (2022). Effect of traditional Chinese medicine-based rehabilitation nursing combined with scalp acupuncture on negative emotions and quality of life of patients with stroke: A randomized controlled trial Medicine 101 (43) :e31330.

[18] Li J; Zhao H; Xie Y; Li J; Li Q; Chen X; Zhang W (2022). Clinical efficacy of comprehensive therapy based on traditional Chinese medicine patterns on patients with pneumoconiosis: a pilot double-blind, randomized, and placebo-controlled study Frontiers of medicine 16 (5) :736-744.

[19] Yang S; Jia Y; Zhang J; Zhai W; Xie Y; Guo J (2024). A randomized controlled trial: The efficacy and safety of Bushen Huoxue formula in the management of lower back pain from lumbar disc herniation Medicine 103 (7) :e37293.

[20] Wang Y; Jia Y; Liu X; Yang K; Lin Y; Shao Q; Ling J (2024). Effect of Chaihu-Shugan-San on functional dyspepsia and gut microbiota: A randomized, double-blind, placebo-controlled trial Journal of ethnopharmacology 322 :117659.

[21] Li J; Sun Y; Zhang C; Thomas K; Lin W; Cheng C; Li H; Zhu Q; Ma S; Hua Q; Shi Q; Zheng X (2023). A randomized, controlled clinical trial of acupoint catgut embedding as an effective control of functional anorectal pain Medicine 102 (44) :e35462.

[22] Luo H; Gong R; Zheng R; Tan J; Chen R; Wu J; Ma T (2023). Dose-effect of long-snake-like moxibustion for chronic fatigue syndrome: a randomized controlled trial Journal of translational medicine 21 (1) :430.

[23] Li Y; Li L; Guo R; Yu H; Wang X; Wang B; Wang Q; Li Z; Zhao H; Temu Q; Chen X; Zhang Y; An J; Cai X; Li A; Qi L; Shang J; He H; Yang D; Lin J; Zhang Y; Zou T (2022). Clinical efficacy of Shugan granule in the treatment of mixed anxiety-depressive disorder: A multicenter, randomized, double-blind, placebo-controlled trial Journal of ethnopharmacology 290 :115032.

[24] Yang G; Kong X; Guo X; Yang Y; Xie C; Lu Y; Liu J; Wu H; Zhang D; Zou Y; Zhang C; Hong J; Ma X (2023). Effects of electroacupuncture on dry eye: A pilot randomized controlled trial Acta ophthalmologica 101 (3) :e315-e326.

[25] Lyu J; Gao Y; Wei R; Cai Y; Shen X; Zhao D; Zhao X; Xie Y; Yu H; Chai Y; Xie Y (2022). Clinical effectiveness of Qilong capsule in patients with ischemic stroke: A prospective, multicenter, non-randomized controlled trial Phytomedicine : international journal of phytotherapy and phytopharmacology 104 :154278.

[26] Zhang Y; Cao Y; Wang L (2020). The effects of a new, improved Chinese medicine, Gengnianchun formula granules, on hot flushes, depression, anxiety, and sleep in Chinese peri- and postmenopausal women: a randomized placebo-controlled trial Menopause (New York, N.Y.) 27 (8) :899-905.

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