Background:Auricular therapy (AT) has attracted significant interest as a potential treatment for polycystic ovary syndrome (PCOS). A systematic review and a meta-analysis were conducted to evaluate the effectiveness and safety of AT in managing PCOS by analyzing evidence from randomized controlled trials (RCTs). Methods:Eight electronic databases were searched from their inception until December 22, 2024. Two independent reviewers performed study screening, data extraction, and quality assessment using the Cochrane Collaboration's Risk of Bias tool. A random-effects meta-analysis was conducted to synthesize data from included studies using mean differences (MDs). This study was registered with the Open Science Framework (OSF) (DOI: 10.17605/OSF.IO/VBPSM). Results:This systematic review and meta-analysis, which included 18 RCTs involving 1,231 patients with PCOS, found insufficient evidence to support the efficacy of AT as a stand-alone intervention for PCOS. However, AT used as an adjunct therapy exerted beneficial effects on PCOS outcomes. For AT combined with traditional Chinese medicine (TCM) formula versus TCM formula alone, a reduction in body mass index (BMI) (MD: -0.82, 95% confidence interval (CI): -1.60 to -0.03, P = 0.04) was observed. Moreover, the reductions were associated with scores on the Self-rating Anxiety Scale (SAS) (MD: -3.81, 95% CI: -6.26 to -1.36, P = 0.002) and Self-rating Depression Scale (SDS) (MD: -4.22, 95% CI: -7.74 to -0.69, P = 0.02). No significant effect was identified for hormonal profiles (luteinizing hormone (LH) levels, LH/follicle-stimulating hormone (FSH) ratio, testosterone (T) levels), metabolic parameters (fasting blood glucose (FBG) levels, fasting insulin (FINS) levels, or Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)), or waist-hip ratio (WHR). For AT combined with metformin versus metformin alone, a reduction was observed in BMI (MD: -0.77, 95% CI: -1.23 to -0.31, P = 0.0009), WHR (MD: -0.03, 95% CI: -0.05 to -0.02, P < 0.0001), and LH levels (MD: -0.81, 95% CI: -1.05 to -0.57, P < 0.0001). For AT combined with acupuncture versus acupuncture alone, a reduction was observed in BMI (MD: -3.21, 95% CI: -5.09 to -1.33, P = 0.0008), LH levels (MD: -0.80, 95% CI: -1.16 to -0.43, P < 0.0001), and HOMA-IR (MD: -0.10, 95% CI: -0.16 to -0.05, P < 0.0001). A reduction was also associated with the LH/FSH ratio (MD: -1.39, 95% CI: -1.76 to -1.02, P < 0.0001). However, no significant effect was identified for WHR, and the evidence was insufficient for the effect on FINS levels. Conclusion:Our findings suggest that adjunctive AT may be associated with improvements in key clinical outcomes, including anthropometric measures (BMI, WHR), hormonal parameters (T levels, LH levels, LH/FSH ratio), and psychological health. However, the specific benefits may vary depending on the co-intervention. Although the included studies did not report any serious adverse events, this should be interpreted with caution due to the potential for underreporting. Methodological limitations warrant careful interpretation of our findings, including a high risk of bias, high heterogeneity, and small sample sizes. These limitations highlight the need for further high-quality, well-designed, and adequately powered RCTs to confirm the efficacy and safety of AT in PCOS management. Systematic review registration:https://osf.io/vbpsm/, identifier DOI: 10.17605/OSF.IO/VBPSM.

Breast cancer is a leading malignancy and a significant cause of mortality in women. The coexistence of depression has been associated with a more aggressive breast cancer progression. Si–Ni–San (SNS), a Traditional Chinese medicine (TCM) formula, has been traditionally used for the treatment of depression. This clinical trial aimed to evaluate the effectiveness and safety of SNS in relieving depression in breast cancer patients, and explore its molecular mechanism. A randomized, double-blind, placebo-controlled crossover trial was conducted in breast cancer patients with mild to moderate depression (MMD). Patients were asked to participate over a four-week SNS treatment and a four-week placebo intervention in randomized order, with a two-week washout period. The primary endpoint was the change of Hamilton Depression Scale-24 (HAMD-24) score. Secondary endpoints were the changes of Functional Assessment of Cancer Therapy—Breast (FACT-B) and syndrome score of Traditional Chinese medicine (TCMSS). Liver function test (LFT) and mental status examination (MSE) were conducted to ensure the safety. Gut microbiota, serum metabolomics, cytokine profiling and T lymphocyte subsets were tested to explore the molecular mechanisms. A total of 53 patients completed the trial. Compared to placebo intervention, SNS treatment significantly reduced HAMD-24 score (4.46 ± 4.403 (95

This narrative review comprehensively elaborates the complicated interleukin (IL)-macrophage polarization axis as the core pathogenesis of allergic rhinitis (AR), focusing on layered molecular regulatory mechanisms covering inflammatory signaling, metabolic reprogramming and epigenetic modulation. Pro-inflammatory IL-1β, IL-6, IL-17 and TNF-α bind to TLR receptors to activate NF-κB, NLRP3 inflammasome and PI3K/Akt cascades, triggering M1 macrophage overactivation and acute nasal congestion, rhinorrhea via robust inflammatory mediator release. By contrast, anti-inflammatory IL-4 and IL-10 predominantly activate STAT6 signaling to drive abnormal M2 macrophage accumulation, sustaining persistent type 2 inflammation and irreversible nasal tissue remodeling; notably, IL-17 presents concentration-dependent bidirectional regulation on macrophage phenotypes. Metabolic reprogramming featured with glycolysis-oxidative phosphorylation switch, together with DNA methylation, histone modification and non-cRNA-mediated epigenetic regulation, serve as vital downstream executors linking IL signals to macrophage polarization imbalance. Conventional glucocorticoids, antihistamines and monoclonal antibodies including omalizumab and dupilumab (targeting IL-4Rα) exert therapeutic efficacy via intervening this axis, while multiple natural herbal constituents and classic TCM formulas also modulate relevant inflammatory pathways to alleviate AR symptoms. For translational application, the CD206/CD86 macrophage polarization ratio is highlighted as a representative candidate biomarker for disease severity assessment. Collectively, this review integrates multi-layered regulatory evidence and lays theoretical support for developing novel precision-targeted anti-allergic therapies.

Allergic rhinitis (AR) is a common chronic inflammatory disease of the upper respiratory tract and has become a significant global public health issue. With increasing globalization and environmental challenges, the factors contributing to AR pathogenesis have expanded, leading to a marked rise in its global incidence. Current clinical treatment guidelines recommend antihistamines, glucocorticoids, and leukotriene receptor antagonists for managing the clinical symptoms and pathological changes associated with AR. However, as patients' expectations for quality of life increase, concerns regarding the recurrent nature of AR and the long-term use of pharmacological treatments have grown, particularly concerning the potential side effects and sustained efficacy of these medications. Therefore, the pathogenesis of AR remains a key research focus and a critical entry point for therapeutic intervention. In this context, Traditional Chinese Medicine (TCM), with over 2500 years of clinical experience and a comprehensive theoretical framework, has long recognized the condition and offers therapeutic strategies to treat or delay its onset. TCM exerts its effects through multiple mechanisms, including immunomodulation, suppression of oxidative stress, regulation of gut microbiota, inhibition of inflammatory responses, and restoration of normal cellular autophagy and apoptosis. This paper reviews ex vivo and in vivo studies on the use of TCM in AR treatment, focusing on the modulation of various pathogenic mechanisms and the underlying theoretical basis. It aims to identify potential drug sources and expand therapeutic options for AR. In addition, this review analyzes the administration routes and treatment durations of various TCM interventions, offering insights into the development of safe and effective targeted therapies. It also provides guidance for future experimental and clinical research while highlighting the current challenges facing TCM in the management of AR.

This study aimed to investigate the association between Obstructive Sleep Apnea (OSA) and Tinnitus using NHANES data from 2005 to 2020. This study analyzed data from NHANES (National Health and Nutrition Examination Surveys) conducted between 2005 and 2020, and included 4871 participants aged 16 or older. OSA was assessed using the Multivariate Apnea Prediction Index and the variables from the National Health and Nutrition Examination Survey. Tinnitus was defined as participants who reported being bothered by a ringing, roaring, or buzzing sound in the ears or head lasting 5 min or more during the past 12 months. Logistic regression models were employed to examine the association between OSA and Tinnitus. The study cohort had an overall prevalence of Tinnitus of 16.5

PURPOSE:To construct a nomogram for predicting metabolic syndrome (MetS) in women with polycystic ovary syndrome. METHODS:In this retrospective study, we analyzed clinical and biochemical data from 859 Chinese women diagnosed with PCOS. Univariable logistic regression and forward stepwise logistic regression were employed to identify independent predictors of MetS. A predictive nomogram was developed that integrates age, acne status, body mass index (BMI), fasting insulin levels (FINS), and the ApoB/ApoA ratio. The model's discriminative performance, calibration accuracy, and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC), calibration curves accompanied by Brier scores, Hosmer - Lemeshow tests, decision curve analysis (DCA), and clinical impact curves (CIC). Internal validation was conducted through bootstrap resampling over 1,000 iterations. RESULTS:The nomogram exhibited strong discriminative capability with an AUC of 0.874 (95% CI: 0.850-0.899), surpassing BMI alone which had an AUC of 0.824 (p < 0.0001). Both the calibration curve and Hosmer - Lemeshow test indicated satisfactory model fit. DCA and CIC analyses suggested that the nomogram could provide net clinical benefits for risk stratification among PCOS patients. CONCLUSIONS:The proposed nomogram accurately predicts MetS risk in PCOS patients, supporting early identification and individualized management.

BackgroundTriglycerides and fasting glycemic index are biomarkers used to assess the risk of insulin resistance and metabolic syndrome. It and its derivatives such as the TyG-BMI index are currently able to reflect the degree of insulin resistance and are closely related to a variety of metabolic diseases. The relationship between the TyG-BMI index and hearing loss remains underexplored, particularly in the context of aging and public health. This study investigates the association of the TyG index, BMI index, and TyG-BMI index with hearing loss, with a focus on their potential implications for the aging population.MethodsData from the China Health and Retirement Longitudinal Study (CHARLS) database were analyzed using R software. We applied multi-factor logistic regression, linear regression, restricted cubic splines, and subgroup analyses to assess the impact of the TyG index, BMI index, and TyG-BMI index on hearing loss across different age groups.ResultsThe TyG index was not significantly associated with hearing loss. However, both the BMI index and the TyG-BMI index exhibited a positive correlation with hearing loss, particularly among older individuals. The results suggest that as the population ages, higher BMI and TyG-BMI indices may increase the risk of hearing impairment.ConclusionWhile the TyG index does not show a significant link to hearing loss, higher BMI and TyG-BMI indices are associated with an increased risk of hearing loss, especially in older adults. These findings highlight the importance of considering aging-related factors in public health initiatives aimed at preventing hearing loss. Further research is needed to elucidate the mechanisms underlying these associations and to develop age-inclusive strategies for addressing hearing impairment in the aging population.

INTRODUCTION Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4％of the total disease burden.1 Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent deficits in social communication and interaction, alongside restricted, repetitive patterns of behavior. This study aimed to analyze the temporal trends and project the future burden of ASD in Japan. Using Global Burden of Disease (GBD) 2021 data, we analyzed prevalence, disability-adjusted life years (DALYs), and age-standardized rates (ASR) (1992-2021) through age-period-cohort modeling, joinpoint regression, and autoregressive integrated moving average (ARIMA) forecasting. Age-standardized prevalence rate (ASPR) increased significantly (Average Annual Percentage Change [AAPC]=0.2744; 95%CI:0.2606-0.2882), with males disproportionately affected (male-to-female ratio 4:1). By 2050, crude prevalence is projected to decline 14.2%, while ASPR will rise 18.0%. Japan’s ASD burden exceeds global averages, necessitating targeted interventions across the lifespan. These findings highlight the increasing burden of ASD in Japan and underscore the urgent need for enhanced healthcare planning and resource allocation.

Allergic rhinitis (AR) is a prevalent chronic inflammatory allergic disease, characterized by paroxysmal nasal congestion, itching, sneezing, and rhinorrhea, which affects mental health in severe cases. Western medical treatments primarily rely on glucocorticoids and antihistamines, which, while providing symptomatic relief, are associated with varying degrees of side effects and fail to ensure long-term efficacy. The pathogenesis of AR is intricately related to immune system dysregulation, and the treatment of AR has not yet been fully clarified. Natural products, having co-evolved with humans over millennia, boast structural diversity and rich biological activity, and they can precisely interact with intracellular targets such as enzymes, receptors, and ion channels, positioning them as a vital resource for therapeutic interventions. Notably, validated natural products often contain multiple active constituents, which confer broader therapeutic effects compared to single-component compounds. These constituents also exhibit lower acute toxicity than synthetic drugs, ensuring superior long-term. The synergistic interactions among their components endow them with dual potential for both prevention and treatment. Natural products modulate AR pathogenesis through various signaling pathways, addressing key etiological factors such as immune dysregulation, inflammatory responses, as well as oxidative stress. These developments will drive research and application of natural products in AR management, unlocking their untapped potential. This review systematically examines the mechanisms by which natural products regulate AR pathogenesis through signaling pathways, drawing on both animal studies and laboratory research, though clinical data are still relatively limited. By elucidating their specific mechanisms of action, this work not only provides novel insights for developing effective, long-term AR management drugs but also offers scientific guidance for experimental research and clinical application in AR therapeutics.

BackgroundTraditional Chinese medicine (TCM) comprising herbal formulas has been used for millennia to treat various diseases, such as insomnia, based on distinct syndrome types. Although TCM has been proposed to be effective in insomnia through gut microbiota modulation in animal models, human studies remain limited. Therefore, this study employs machine learning and integrative network techniques to elucidate the role of the gut microbiome in the efficacies of two TCM formulas — center-supplementing and qi-boosting decoction (CSQBD) and spleen-tonifying and yin heat-clearing decoction (STYHCD) — in treating insomnia patients diagnosed with spleen qi deficiency and spleen qi deficiency with stomach heat.MethodsSixty-three insomnia patients with these two specific TCM syndromes were enrolled and treated with CSQBD or STYHCD for 4 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) every 2 weeks. In addition, variations in gut microbiota were evaluated through 16S rRNA gene sequencing. Stress and inflammatory markers were measured pre- and post-treatment.ResultsAt baseline, patients exhibiting only spleen qi deficiency showed slightly lesser severe insomnia, lower IFN-α levels, and higher cortisol levels than those with spleen qi deficiency with stomach heat. Both TCM syndromes displayed distinct gut microbiome profiles despite baseline adjustment of PSQI, ISI, and IFN-α scores. The nested stratified 10-fold cross-validated random forest classifier showed that patients with spleen qi deficiency had a higher abundance of Bifidobacterium longum than those with spleen qi deficiency with stomach heat, negatively associated with plasma IFN-α concentration. Both CSQBD and STYHCD treatments significantly improved sleep quality within 2 weeks, which lasted throughout the study. Moreover, the gut microbiome and inflammatory markers were significantly altered post-treatment. The longitudinal integrative network analysis revealed interconnections between sleep quality, gut microbes, such as Phascolarctobacterium and Ruminococcaceae, and inflammatory markers.ConclusionThis study reveals distinct microbiome profiles associated with different TCM syndrome types and underscores the link between the gut microbiome and efficacies of Chinese herbal formulas in improving insomnia. These findings deepen our understanding of the gut-brain axis in relation to insomnia and pave the way for precision treatment approaches leveraging TCM herbal remedies.

Background Breast cancer remains a significant global health challenge. Understanding its etiological factors, particularly the role of immune system components, is crucial. This study leverages Mendelian randomization (MR) to investigate the causal relationship between various immune cell features and the risk of developing breast cancer. Methods Utilizing two-sample MR analysis, we examined 731 immune cell features across 7 groups for their potential causal links to breast cancer. We analyzed genome-wide association studies (GWAS) data of 257,730 Europeans, comprising 17,389 cases and 240,341 controls, focusing on 24,133,589 single nucleotide polymorphisms (SNPs). Instrumental variables (IVs) were selected based on genetic associations, with rigorous statistical methods employed, including inverse variance weighting (IVW) and weighted median-based estimation. Results Our analysis identified 20 immunophenotypes with significant causal associations with breast cancer risk. Notably, contain B cell, mature T cell, T + B + NK (TBNK) cells, regulatory T (Treg) cell, Classic dendritic cells (cDCs), Monocyte, and Myeloid cell group features displayed positive or negative correlations with breast cancer. For instance, specific B cell phenotypes were found to have both positive and negative causal relationships with breast cancer. Additionally, reverse MR analysis revealed no significant causal effects of breast cancer on these immune characteristics. Conclusions This study underscores the complex interplay between various immune cell phenotypes and breast cancer risk. The identified immunophenotypes could be potential biomarkers or targets for future therapeutic interventions. Our findings contribute to a deeper understanding of the immunological dimensions of breast cancer etiology.

Cuproptosis, a copper-dependent programmed cell death process, holds promise for controlling cell death in tumor cells. Autophagy, a fundamental cellular process, has been linked to various aspects of cancer, such as proliferation, migration, and drug resistance. This research is centered on the investigation of autophagy- and cuproptosis-related long noncoding RNAs (lncRNAs) and the establishment of a prognostic model for head and neck squamous cell carcinoma. RNA sequencing data from head and neck squamous cell carcinoma patients in The Cancer Genome Atlas database identified cuproptosis-related lncRNAs via Pearson analysis. Patients were divided into training and testing sets. A prognostic model developed in the training set using univariate-least absolute shrinkage and selection operator (Lasso) and multivariate Cox regression was tested for accuracy. Kaplan-Meier analysis showed high-risk patients had poorer outcomes. Cox regression confirmed the model's risk score as an independent prognostic indicator, with receiver operating characteristic and decision curve analyses validating its predictive accuracy. Thirteen lncRNAs associated with autophagy and cuproptosis were identified through bioinformatics analysis. Lasso regression narrowed this to 3 significant prognostic lncRNAs. Based on median risk scores, patients were classified into high-risk and low-risk groups. Kaplan-Meier survival curves revealed significant differences between these groups (P < .01). Through a set of bioinformatics analyses, we identified 13 autophagy- and cuproptosis-related lncRNAs. By Lasso regression, 3 prognostic-related lncRNAs were further selected. We also investigated these 3 lncRNAs in relation to clinicopathologic features. The principal component analysis visually showed differences between the high-risk and low-risk groups.

Allergy rhinitis (AR) is becoming more common and has serious medical and societal consequences.Sneezing, paroxysmal nasal blockage, nasal itching, mucosal edema, coughing, and rhinorrhea are symptoms of this type I allergic immunological illness.Immunoglobulin E-mediated inflammation is the cause of it.Because AR is prone to recurrent attacks, extended medication therapy may impair its effectiveness.In addition to negatively affecting the patients' physical health, this can also negatively impact their mental health.During AR development, there are inflammatory and oxidative stress responses that are linked to problems in a number of signal transduction pathways.By using the terms "allergic rhinitis", "traditional Chinese medicine", "inflammation", and "oxidative stress", we screened for pertinent research published over the previous five years in databases like PubMed.We saw that NF-KB, TLR, IL-33/ST2, PI3K/AKT, MAPK, and Nrf2 are some of the most important inflammatory and oxidative stress pathways in AR.Studies have revealed that antioxidant and anti-inflammatory therapy reduced the risk of AR and was therapeutic; however, the impact of the therapy varies widely.The Chinese medical system places a high value on traditional Chinese medicine (TCM), which has been there for virtually all of China's 5000-year history.By influencing signaling pathways related to inflammation and oxidative stress, Chinese herbal medicine and its constituent compounds have been shown to prevent allergic rhinitis.This review will focus on this evidence and provide references for clinical treatment and scientific research applications.

Abstract Background Certain studies have indicated a link between obstructive sleep apnea and insulin resistance in specific populations. To gain more clarity, extensive research involving a broad sample of the overall population is essential. The primary objective of this study was to investigate this correlation by utilizing data from the National Health and Nutrition Examination Survey database. Methods The analysis incorporated data from the National Health and Nutrition Examination Survey database spanning the time periods from 2005 to 2008 and from 2015 to 2018, with a focus on American adults aged 18 years and older after applying weight adjustments. Key variables such as obstructive sleep apnea, triglyceride glucose index, and various confounding factors were considered. A generalized linear logistic regression model was used to investigate the association between obstructive sleep apnea and the triglyceride glucose index, with additional exploration of the consistency of the results through hierarchical analysis and other techniques. Results The study included participants aged between 18 and 90 years, with an average age of 46.75 years. Among the total sample, 50.76% were male. The triglyceride glucose index demonstrated a diagnostic capability for obstructive sleep apnea, with an AUC of 0.701 (95% CI: 0.6619–0.688). According to the fully adjusted model, individuals in the fourth quartile of the triglyceride glucose index showed an increased likelihood of having obstructive sleep apnea compared to those in the first quartile (OR: 1.45; 95% CI: 1.02–2.06; P < 0.05). Subgroup analysis indicated that male sex (OR: 2.09; 95% CI: 1.76–2.45; P < 0.05), younger age (OR: 2.83; 95% CI: 2.02–3.96; P < 0.05), white ethnicity (OR: 2.29; 95% CI: 1.93–2.73; P < 0.05), and obesity (OR: 1.54; 95% CI: 1.28–1.85; P < 0.05) were correlated with an elevated risk of OSA. Conclusions This study demonstrated a strong association between an elevated TG index and OSA. Additionally, the triglyceride glucose index could serve as an independent predictor of obstructive sleep apnea.

We evaluated the relationship between sleep factors and tinnitus risk using data from the US National Health and Nutrition Examination Survey (2007-2012), focusing on adults aged 20 to 80 years. Our analysis included 4354 participants, with sleep patterns categorized as healthy, intermediate, or poor. We observed that both short (odds ratio [OR]: 1.43) and long (OR: 1.48) sleep durations increased the risk of tinnitus compared with the healthy range (7-9 hours). Additionally, sleep disturbances were significantly correlated with tinnitus (OR: 1.52), with the strongest association occurring in individuals with poor sleep patterns (OR: 1.71). The results of the weighted logistic regression analysis underscored these findings.

Abstract Exploring whether allergic rhinitis increases the risk of obstructive sleep apnea (OSA). Complete records of allergic rhinitis and sleep about OSA from the 2005–2006 National Health and Nutrition Examination Survey. The American people were divided into two groups: AR, NAR. OSA was assessed by three main signs and symptoms from the questionnaire. Multivariable logistic regression after adjusting for covariates was conducted to investigate the association of OSA with AR or NAR patterns. Among the 4864 participants, the prevalence of OSA was higher among AR participants compared to NAR participants (P < 0.0001).And AR participants also had other sleep problem. Our findings point out the hazard of OSA was once greater in AR affected person than NAR patient. And in contrast with NAR affected person AR affected person additionally have different sleep problem.

Background:Post-stroke cognitive impairment and dementia (PSCID) is the main source of morbidity and mortality after stroke worldwide. It is one consequence of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Cognitive impairment and dementia after the clinical stroke may contribute to the clinical expression of PSCID, which are prevalent clinical symptoms, especially in the elderly. Current problems in the field of PSCID are related to a lack of harmonization of the classification and definition, deficiency of well-defined diagnosis, deficiency of standardized and objective treatment plans, etc. Auricular therapy can effectively improve the symptoms of patients with PSCID. However, there has been no systematic review of auricular therapy for PSCID. This study aimed to evaluate the efficacy and safety of auricular therapy in patients with PSCID. Methods:Before December 2022, a systematic literature search was conducted using the following databases: PubMed, Embase, SinoMed (previously called the Chinese Biomedical Database), Web of Science, Chinese National Knowledge Infrastructure, and Wanfang Database. Review Manager software (version 5.3) will be used for statistical analysis; otherwise, descriptive analysis or subgroup analysis will be conducted. The quality of evidence for outcomes will be assessed with the Grading of Recommendations Assessment, Development and Evaluation approach. Results:This meta-analysis further confirmed the beneficial effects of auricular therapy in patients with PSCID. Conclusion:This study investigated the efficacy and safety of auricular therapy in patients with PSCID, providing clinicians and patients with additional options for this disease.

Introduction Insulin resistance (IR) could be regarded as a therapeutic target for metabolic diseases. Therefore, multiple therapeutic strategies that target IR should be applied to provide a more effective means of treatment. It aims to determine Tuina’s efficacy and safety for IR through this systematic review and meta-analysis. Methods From the inception to July 31, 2023, we will search four English databases (Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science) and two Chinese databases (China National Knowledge Infrastructure and the Chinese Science and Technology Periodical Database). We will search and include studies of both human and animal models that evaluate Tuina’s effects on insulin sensitivity or resistance. Data selection, data extraction, and risk of bias assessment will be made by two independent reviewers. We will evaluate the methodological quality of all included studies and conduct meta-analyses using Review Manager Software 5.4.1. Discussion In both animal and human studies, the effects and safety of Tuina for IR will be evaluated. The evidence generated bythis study will validate effects and safety of Tuinain treating IR and inform future research and clinical decision-making. Trail registration PROSPERO Registration ID: CRD42022360128 .