This article reviews the historical evolution of combined acupuncture and medication and the construction of its modern theoretical system, and sorts out its research status. It shows that combined acupuncture and medication can not only enhance the clinical efficacy of a single medication or acupuncture, but also reduce the toxic and side effects caused by drug use. Under this premise, combined acupuncture and medication further demonstrates the potential of "efficacy enhancement and drug reduction", that is, while ensuring or even improving the therapeutic effect, it reduces drug dosage and delays the need for drug dosage increase or drug replacement. This concept expands from the traditional "efficacy enhancement and toxicity reduction" to "efficacy enhancement and drug reduction", marking a new direction for the development of this field. The combined acupuncture and medication model and its concept of "efficacy enhancement and drug reduction" have broad application prospects in the prevention and control of chronic diseases.

As a distinctive feature of traditional Chinese medicine, the combined use of acupuncture and medication has demonstrated unique advantages in the prevention and treatment of major diseases in recent years. Its value is reflected not only in the efficacy level, but also in providing multi-dimensional and multi-level intervention ideas for the research on complex pathogenesis. The combination of acupuncture and medication has undergone an evolution from experience accumulation to the standardized summarization, and then to mechanistic exploration. Modern studies have revealed that the synergy of acupuncture and medication can be interpreted from three perspectives: action level, temporal characteristics and spatial coupling. It embodies a synergistic mechanism that combines central regulation with peripheral intervention, complements immediate effect with sustained and prolonged release, and integrates multi-pathway signals. In recent years, with the development of neuroimaging, single-cell omics and multi-omics integration, the mechanism of combined acupuncture and medication will be decoded more accurately. The clinical transformation of the therapeutic strategy of combined acupuncture and medication in the field of major diseases will provide a new paradigm for comprehensive prevention and treatment under the integration of multiple disciplines.

To observe the clinical efficacy of combined acupuncture and medication in the treatment of obesity in patients with polycystic ovary syndrome (PCOS) of phlegm-dampness syndrome.

A total of 60 obese patients with PCOS of phlegm-dampness syndrome, who visited the Gynecology Outpatient Department and TCM Department of Liaobu Hospital in Dongguan City from January 2022 to June 2023, were selected. According to the random number table method, the patients were randomly divided into a control group (30 cases) and an observation group (30 cases). The control group was given oral metformin treatment, three times a day, 0.5 g each time, for three consecutive months. On the basis of the control group, the observation group was additionally treated with acupuncture combined with TCM decoction: acupuncture treatment was given once every other day. Two acupoint prescriptions were used alternately: prescription 1 included Zhongwan (CV 12), Tianshu (ST 25), Zigong (EX-CA1), Guilai (ST 29), Qihai (CV 6), Zusanli (ST 36), Fenglong (ST 40), and Yinlingquan (SP 9); prescription 2 included Pishu (BL 20), Ganshu (BL 18), Shenshu (BL 23), Weizhong (BL 40), Ciliao (BL 32), and Sanyinjiao (SP 6). The needles were retained for 30 minutes.The TCM decoction was a self-formulated "Bushen Jianpi Huatan Decoction" (Kidney-Nourishing, Spleen-Strengthening, and Phlegm-Resolving Decoction), 1 dose per day, for 3 consecutive months. Changes in TCM syndrome scores, body composition, and glucose-lipid metabolism were observed in both groups before and after treatment, and safety assessment was conducted.

After treatment, the TCM syndrome scores of both groups in terms of menstrual cycle, menstrual flow, menstrual color, menstrual texture, epigastric and abdominal fullness, tasteless mouth with sticky feeling and excessive phlegm, amount and color of leukorrhea, stool condition, and total score were all lower than those before treatment (observation group: Z=-3.923, -4.193, -5.012, -4.778, -4.961, -4.960, -4.810; control group: Z=-2.113, -2.424, -2.565, -3.611, -2.558, -2.842, -4.472; all P<0.05), and the scores of the observation group were lower than those of the control group (Z=3.800, 3.083, 2.553, 2.206, 2.249, 2.500, 5.234; all P<0.05). In regard of the body composition indicators, after treatment, indicators of both groups including body mass index (BMI), fat mass, body fat percentage, and visceral fat index were all lower than those before treatment (observation group: t=11.629, 3.562, 9.750, 8.954; control group: t=9.204, 3.278, 12.618, 6.740; all P<0.05), and the indicators of the observation group were lower than those of the control group (t=-3.091, -2.995, -3.826, -4.277; all P<0.05). Indicators of both groups including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and triglycerides (TG) were all lower than those before treatment (observation group: t=6.841, 9.740, 12.308, 4.842, 5.817; control group: t=2.377, 6.251, 5.182, 2.431, 2.695; all P<0.05), and the indicators of the observation group were lower than those of the control group (t=-2.568, -2.557, -3.259, -2.395, -2.280; all P<0.05).

Combined acupuncture and medication has a significant efficacy in the treatment of obesity in PCOS patients with phlegm-dampness syndrome, and it is worthy of clinical promotion.

In recent years, the combination of acupuncture and medication in the treatment of knee osteoarthritis (KOA) has continuously broken through traditional joint methods. From acupuncture combined with oral administration of traditional Chinese medicine (TCM) and external TCM therapy, a variety of combined acupuncture-medication technologies have been gradually developed, such as electroacupuncture-guided drug delivery, nano-microneedles, and chemical drug-loaded acupuncture instruments. These technologies have further increased the concentration of drugs accumulated at the lesion site and prolonged their action time.Meanwhile, the combination of acupuncture and medication, integrated with TCM syndrome differentiation, has demonstrated individualized application schemes, showing better effects in analgesia, anti-inflammation, and cartilage protection. Studies have shown that, in the treatment of KOA, the combined use of acupuncture and medication is superior to single acupuncture or single medication in relieving pain, improving joint function, inhibiting inflammatory responses, and delaying joint degeneration. Moreover, emerging combined acupuncture-medication technologies are expected to promote the development of precision and standardization in the application of acupuncture-medication combination for KOA treatment.

The combination of acupuncture and Chinese medication is an essential treatment method in traditional Chinese medicine (TCM) system. Guided by the concept of holism , it achieves multi-targeted and multi-dimensional disease prevention and treatment effects by synergistically exerting the external stimulation effect of acupuncture and the internal regulatory effect of decoction. Professor Gao Shuzhong advocates the combined use of acupuncture and medication, as well as integrated internal and external treatment in clinical practice. points out that the key pathogenesis lies in the lung and stomach meridians, which is mostly caused by external attack of wind-heat, accumulated heat in the stomach, or internal stagnated heat in the lung and stomach complicated by external pathogenic factors. In clinical practice, he is skilled in applying the periosteal needling method at the Shangque (Extra Points), combined with pricking and bloodletting at Shaoshang (LU 11) and Shangyang (LI 1). Meanwhile, internal administration of traditional Chinese medicine is adopted, using Shengjiang Powder (Shengjiang San) combined with Yinqiao Powder (Yinqiao San) with appropriate modifications. For diaphragmatic spasm, he holds that the core pathogenesis is the reversal and disturbance of qi movement affecting the diaphragm. In clinical practice, acupoints are selected based on syndrome differentiation for acupuncture, combined with external application of traditional Chinese medicine or internal administration of proven formulas. This article selects Professor Gao Shuzhong's clinical experience in treating acute tonsillitis and diaphragmatic spasm with the combination of acupuncture and medication, aiming to provide useful references for the clinical application of this integrated therapy.

Migraine is a common and refractory disease in Western medicine, characterized by a prolonged course and frequent occurrence among young and middle-aged individuals. It is characterized by recurrent, unilateral pulsating headache. In contrast, acupuncture therapy has gained wider acceptance due to its high safety, solid efficacy, and few adverse effects. Based on the traditional Chinese medicine theory, Professor Ma Tieming has formed a unique pathogenesis view of "wind causes movement, and the liver is the viscus of wind", and put forward the innovative acupuncture theory of "fine-needle regulating the spirit, thick-needle regulating the form", which corresponds to the modern neurophysiological mechanism. By combining acupuncture and medicine and syndrome-differentiation and treatment, good curative effects have been achieved. Starting from the academic thought basis and clinical experience, this paper introduces Professor Ma Tieming's experience in treating migraine, providing new ideas for the modernization of traditional Chinese medicine and the treatment of migraine with the combination of acupuncture and medicine.

Professor Guo Yi proposed the "Four-Unblocking Method" for treating nonspecific low back pain (NSLBP), which consists acupuncture, cupping, tuina (Chinese therapeutic massage), and bone-setting. With the integration of these four techniques as its core, this method is rooted in the traditional Chinese medicine (TCM) theories of "pain from obstruction" (butong ze tong) and "pain from malnourishment" (burong ze tong), while also incorporating the meridian theory and the holistic concept of TCM. Through the combined application of acupuncture, cupping, tuina, and bone-setting, it functions to dredge the meridians, regulate qi and blood, release tense muscles and skin, and realign the muscles and bones. The specific procedures are as follows: first, using warming acupuncture technique to unblock the Du meridian and relieve pain; second, employing cupping therapy in the sequence of "flush cupping, moving cupping and short-duration retained cupping" to regulate qi and blood; third, Gentle and mild tuina and bone-setting manipulations are used to relax the muscular texture, soothe the tendons, and realign the bones. In clinical practice, the application of the "Four Unblocking Method" in treating NSLBP can significantly relieve pain symptoms and restore limb movement function. This treatment protocol emphasizes individualized design, conducting comprehensive treatment based on the etiological factors and pathogenesis characteristics of different patients. It has demonstrated remarkable clinical efficacy and possesses considerable promotion value.

To systematically review the current status of randomized controlled trials (RCTs) on acupuncture combined with traditional Chinese tedicine (TCM) for low back pain (LBP) and evaluate their reporting quality.

Computer-based retrieval was conducted in the China National Knowledge Infrastructure (CNKI), VIP Chinese Journal Service Platform (VIP), and Wanfang Data Knowledge Service Platform (Wanfang) for RCT literatures on acupuncture combined with TCM in the treatment of LBP, published from the establishment of each database to December 31, 2024. Literatures were screened according to inclusion and exclusion criteria. Basic literature information, research elements, and methodological contents were extracted for bibliometric analysis. The reporting quality of literatures was evaluated with reference to the Consolidated Standards of Reporting Trials (CONSORT) Statement, Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA), and Consolidated Standards of Reporting Trials for TCM Compound Formulas (CONSORT-CHM Formulas).

A total of 482 RCTs were included. Among them, 443 (91.9%) were published in the past 10 years, 19 (3.9%) were published in core journals, and 371 (77.0%) had no funding support. Regarding research focus and intervention methods: 43.8% of the literatures focused on intervertebral disc herniation; 50.2% used filiform needle acupuncture; the top 6 acupoints in terms of frequency of use were Weizhong (BL 40), Shenshu (BL 23), Huantiao (GB 30), Jiaji (EX-B2), Dachangshu (BL 25), and Ashi Point (EX-UE1).Regarding TCM application: 462 (95.9%) literatures used TCM compound formulas; the top 4 classic compound formulas in frequency of use were Duhuo Jisheng Decoction, Shentong Zhuyu Decoction, Ganjiang Lingzhu Decoction, and Yangyuan Huoxue Decoction; the top 4 TCM syndrome types of LBP were cold-damp syndrome, qi stagnation and blood stasis syndrome, blood stasis syndrome, and liver-kidney deficiency syndrome.Regarding control and outcome measures: The most frequently used western medicine in the control group was celecoxib capsules; the most frequent efficacy evaluation index was total effective rate, followed by the visual analogue scale (VAS) score for LBP; the top 2 functional assessment scales in frequency of use were the Japanese orthopaedic association (JOA) score and oswestry disability index (ODI). Less than 10% of the studies evaluated physical and chemical indicators, among which the top 2 inflammatory factors in frequency of detection were tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). The results of literature reporting quality analysis showed that: the reporting rate of random allocation methods was 57.3%; only 4 literatures included "random" in their titles; 2 literatures distinguished primary and secondary outcome indicators; 1 literature mentioned implementation division of labor; 3 literatures mentioned "blinding" but did not report specific details of blinding implementation; none of the included literatures reported the basis for sample size calculation, allocation concealment, or clinical trial protocol registration information.

The number of RCTs on acupuncture combined with TCM for LBP is growing rapidly, but there are significant limitations: Research focuses on intervertebral disc herniation, with insufficient studies on other types of LBP; Trial design is mainly two-arm, lacking multi-arm comparisons (e.g., acupuncture alone / TCM alone / combination of acupuncture and TCM) and placebo controls; Outcome indicators rely excessively on subjective scales, with a lack of objective indicators; Methodological quality and reporting standardization are generally poor, which seriously affects the credibility and reproducibility of results.

Aquaporin 5 (AQP5) in nasal mucosal epithelial cells is an important hub protein for maintaining local water metabolism and barrier function. Its abnormal distribution and expression can lead to the obstruction of the transportation and transformation of body fluids, keeping allergic rhinitis (AR) in a hyper-secretory state for a long time. The defensive yang transformed by spleen yang, as the first line of defense on the human body surface, has highly similar functions in defending against exogenous pathogens and water transportation to those of AQP5. The traditional Chinese medicine treatment of warming yang and invigorating the spleen can inhibit the activation of the NF-κB pathway and up-regulate the expression of AQP5, thus effectively improving the clinical symptoms and immune indexes of AR with spleen-yang deficiency. Therefore, the abnormal regulation of AQP5 in nasal mucosal epithelial cells may be a key entry point for the study of the essence of AR spleen-yang deficiency syndrome.