Clinical Research on Traditional Chinese Medicine in the Balkans: A Mapping Study of Registered Clinical Trials

Abstract

Traditional Chinese Medicine (TCM) encompasses a broad range of therapeutic approaches, including acupuncture, electroacupuncture, herbal medicine, moxibustion, cupping, and other traditional interventions. Although TCM has gained increasing attention in clinical research worldwide, its investigation and integration within European healthcare systems remain heterogeneous. In the Balkan region, the extent and characteristics of clinical research involving TCM have not been systematically mapped. This study aimed to characterize registered clinical trials investigating TCM interventions conducted in Balkan countries and to describe their geographical distribution, therapeutic modalities, clinical indications, and methodological characteristics. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) were systematically searched for eligible interventional studies. Eleven trials met the predefined eligibility criteria. Research activity was concentrated in Greece (n=5; 45.5%), Slovenia (n=3; 27.3%), and Croatia (n=2; 18.2%), while one multinational trial included a study site in Romania (n=1; 9.1%). Acupuncture and related techniques, including electroacupuncture, auricular acupuncture, and laser acupuncture, represented the predominant TCM interventions. Clinical indications were heterogeneous but focused mainly on pain and musculoskeletal conditions, migraine, and perioperative symptom management. Registered TCM clinical research in the Balkans therefore appears limited, geographically concentrated, and predominantly focused on acupuncture. Mapping this research landscape highlights geographical and therapeutic gaps and may help identify opportunities for broader clinical investigation of TCM interventions within the region.

Keywords: Traditional Chinese Medicine; acupuncture; clinical trials; Balkans; complementary medicine