Traditional Chinese medicine nursing technology for postpartum rehabilitation: A bibliometric and visualized analysis

Abstract

Objective:

This study analyzed published literature on traditional Chinese medicine nursing technology for postpartum rehabilitation using bibliometric methods. The goal was to assess the current state of research, identify emerging research hotspots, and explore future trends, offering valuable insights for ongoing and future studies in this field.

Methods:

Articles published between 2014 and 2024 were retrieved from the Web of Science and China National Knowledge Infrastructure databases. A visual analysis of the data was performed using VOSviewer (v1.6.20) and CiteSpace (v6.3.R1) software. Various metrics were examined, including the annual publication count, contributions by literature and journals, national and institutional outputs, author co-occurrence, keyword co-occurrence, keyword timelines, and keywords with citation bursts.

Results:

As of August 2024, a total of 115 English publications and 2788 Chinese publications were included in the analysis; the highest number of publications was recorded in 2019. Chinese authors and institutions emerged as the primary contributors, whereas England demonstrated significant collaborative efforts. Among all journals, Medicine and Guangming Journal of Chinese Medicine published the most articles in English and Chinese, respectively. High-frequency keywords identified from both English and Chinese publications included “cesarean section,” “acupoint massage,” and “breastfeeding.” Emerging research hotspots focused on “thunder fire moxibustion,” “negative emotion,” “sleep quality,” “Chinese medicine package therapy,” and “wrist-ankle acupuncture.”

Conclusion:

This study comprehensively and objectively summarized the relevant literature on traditional Chinese medicine nursing technology for postpartum rehabilitation. It offers valuable references for both academic research and clinical applications in postpartum care.

1. Introduction

Pregnancy and childbirth induce profound physiological and psychological changes in women, affecting multiple systems, including the reproductive, mammary, circulatory, hematologic, digestive, urinary, and endocrine systems, among others.^[1] The postnatal period, defined as the time immediately after childbirth and extending up to 6 weeks (42 days), is a critical phase for postpartum recovery. If not properly managed, this period is associated with an increased risk of various postpartum complications.^[2] During this stage, maternal healthcare needs extend beyond physical recovery to include emotional well-being, which in turn influences their ability to care for both themselves and their newborns, ultimately impacting broader societal development.^[3] In 2022, the World Health Organization (WHO) issued recommendations on maternal and newborn care to promote a positive postnatal experience, emphasizing the essential nature of high-quality care for women and newborns during this crucial period.^[4]

Traditional Chinese medicine (TCM) has a long-established history and extensive experience in postpartum rehabilitation. TCM nursing technology constitutes a fundamental component of TCM practice, adhering to the principles of “holistic concept” and “syndrome differentiation with tailored nursing.” These techniques integrate classical TCM theories, such as the Qi and blood theory and the meridian doctrine, to systematically regulate postpartum visceral functions and promote both physical and psychological recovery. This approach forms a unique intervention system characterized by “regulating Qi and blood, unblocking meridians, and harmonizing emotional states.”^[5,6] To standardize and advance the scientific development of TCM nursing technology, the National Administration of Traditional Chinese Medicine released the Manual of TCM Nursing Technology for Healthcare Professionals in 2015,^[7] which delineates standardized operational protocols for 18 core techniques, including acupuncture, moxibustion, gua sha, acupoint massage, auricular acupressure, and Chinese medicine package, etc. In recent years, the integration of TCM into mainstream healthcare has been strongly supported by national policies. The Healthy China 2030 initiative^[8] and the Outline of the Strategic Plan for the Development of Traditional Chinese Medicine (2016–2030)^[9] emphasize the role of TCM in postpartum care and encourage further research and clinical applications of TCM nursing technology. Previous studies have demonstrated that TCM nursing technology significantly alleviates postpartum uterine pain,^[10] urinary retention,^[11] postpartum depression,^[12] and lactation-related conditions such as insufficient milk production and breast engorgement.^[13,14] Its advantages of “multi-targeted efficacy and minimal invasiveness” complement modern medicine, particularly in functional rehabilitation and long-term health management. Despite its recognized benefits, the scientific evidence and current research landscape surrounding these techniques remain underexplored.

Bibliometric analysis is a scientific method that utilizes quantitative techniques to reveal publication trends, research distribution patterns, and the evolving landscape of a particular field.^[15] This method facilitates a comprehensive and rapid understanding of research developments. For example, bibliometric techniques have been used to analyze the research status of TCM nursing technology in insomnia treatment based on studies published in English from 2004 to 2021.^[16] Similarly, bibliometric analysis has been utilized to identify research hotspots and trends in TCM for breast cancer treatment from 2013 to 2023.^[17]

The present study systematically collected, analyzed, and visualized research publications on TCM nursing technology for postpartum rehabilitation spanning the period from 2014 to 2024. Using VOSviewer and CiteSpace, this study comprehensively evaluated the distribution and characteristics of these publications, research progress, and emerging research hotspots to serve as a valuable reference for clinical practice and scientific research in postpartum rehabilitation.

2. Methods

2.1. Literature sources and search strategy

Retrieval platforms for this study included the core database of Web of Science (WOS) and the China National Knowledge Infrastructure (CNKI), covering the period from January 1, 2014, to August 3, 2024. Literature related to the topics of “Traditional Chinese Medicine” and “postpartum” was searched. To expand the scope of TCM-related search terms, we referred to the 18 TCM nursing technologies prescribed by the State Administration of Traditional Chinese Medicine. The data retrieval strategy was as follows: Topic = (“Traditional Chinese Medicine” OR “five-element music” OR “gua sha” OR “Scraping Therapy” OR “cupping” OR “moxibustion” OR “auricular” OR “Medical Wax” OR “acupoint” OR “Foot Bath” OR “cold compress” OR “Wet Compress” OR “Drug Smearing” OR “Fumigating and Steaming” OR “Chinese medicine hot pressing compress” OR “Chinese Medicine Ion Introduction” OR “Retention Enema with Chinese Herb” OR “Tuina” OR “massage” OR “tongru” OR “Wrist-ankle Acupuncture”) AND Topic = (“Postpartum” OR “Postnatal” OR “Puerper*” OR “Obstetrics” OR “Cesarean” OR “Caesarean”). To ensure data accuracy, 2 researchers independently conducted manual screening of publications using a dual-review process based on predefined eligibility criteria. Any discrepancies were resolved through consensus-based discussion with a senior researcher.

2.2. Inclusion/exclusion criteria

The inclusion criteria were: studies related to postpartum rehabilitation; studies involving TCM nursing technology as an intervention; and original research articles or review papers. The exclusion criteria were: meeting abstracts, letters, book chapters, editorials, and conference proceedings; and duplicate publications.

2.3. Data analysis

In this study, bibliometric analysis was applied to quantitatively map the research landscape, without evaluating the methodological quality of individual studies. Microsoft Excel, VOSviewer^[18] (v1.6.20), and CiteSpace^[19] (v6.3.R1) were used for data processing and visualization. Microsoft Excel 2019 was used to statistically analyze the annual publication output and journal distribution patterns of the included research articles. VOSviewer was utilized to construct and visualize bibliometric networks, including collaboration networks and keyword co-occurrence maps, whereas CiteSpace was used to identify research frontiers and perform keyword timeline analyses. To mitigate terminological inconsistencies in English, a rigorous keyword normalization procedure was executed. Two researchers independently reviewed all raw English keywords generated by software, merging synonymous expressions through structured replacement protocols (e.g., “breast feeding”/’breastfeeding quality’ to “breastfeeding”; “auricular therapy”/’ear-point buried beans’ to “auricular acupressure”). Discrepancies were resolved by consensus, yielding a refined keyword set for co-occurrence analysis. This process mitigated artificial topic fragmentation and enhanced clustering validity.

2.4. Ethical statement

The study does not involve animals or human subjects, and therefore, ethical approval is not required.

3. Results

3.1. Retrieval of results

In total, 651 relevant English publications and 3811 Chinese publications were identified using the retrieval formula. After thorough screening of titles, keywords, and abstracts, 115 English-language publications, and 2788 Chinese-language publications were selected for further analysis (Fig. 1).

Figure 1.

Flowchart of documents selection. CNKI = China National Knowledge Infrastructure, WOS = Web of Science.

3.2. Annual number of publications

Figure 2 shows the annual trend of English and Chinese publications related to TCM nursing technology for postpartum rehabilitation from 2014 to 2024. The trend generally exhibited an initial increase, followed by a decline, and subsequently stabilized. In the early phase, from 2014 to 2016, the overall number of publications remained relatively stable, with minor fluctuations. Beginning in 2017, there was a substantial surge in publications, peaking at 359 in 2019, which represented 12.37% of all publications. From 2020 to 2023, demonstrated a downward trend; the annual number of published papers stabilized at approximately 250. Because data for 2024 were incomplete, the number of publications appears to be lowest for this year.

Figure 2.

Annual number of publications.

3.3. Literature and journal analysis

An analysis of the 115 English-language articles revealed that they were published across 72 different journals. Medicine published the highest number of articles (n = 9), constituting 7.83% of all English publications (Fig. 3A). Additionally, 9 journals published more than 3 articles each, collectively representing 34.78%, indicating a relative concentration of preferred publication venues. Among these journals, only the Cochrane Database of Systematic Reviews had a high-impact factor of 8.8, whereas the remaining journals had impact factors below 3. Regarding Chinese-language journals, the 2788 articles were published in 385 different journals. Figure 3B presents the top 10 journals with the highest number of publications. Guangming Journal of Chinese Medicine, Inner Mongolia Journal of Traditional Chinese Medicine, and the Journal of Practical Gynecologic Endocrinology collectively published the highest number of papers (n = 258), representing 9.25% of all Chinese-language publications. However, only the Journal of New Chinese Medicine and the Chinese Journal of Traditional Medicine Science and Technology had a composite impact factor above 1. Among these 10 journals, 7 were specialized TCM journals, and 1 was a specialized journal in obstetrics and gynecology.

Figure 3.

Top journals for English and Chinese publications. (A) English-language publications. (B) Chinese-language publications.

3.4. National publications

Statistical analysis of English-language publications indicated that studies on TCM nursing technology for postpartum rehabilitation were published by researchers from 23 different countries between 2014 and 2024. Figure 4 presents the collaborative network among these countries, where node sizes represent the number of publications per country (a larger node indicates a higher number of publications). Connecting lines between nodes indicate collaborative relationships; thicker lines signify stronger research collaborations. China (including Taiwan) produced the highest number of publications, with 57 articles, followed by the United States and Iran, each with 13 articles. England contributed 8 articles, whereas Australia and India each published 6 articles. England demonstrated the highest total link strength, positioning itself as a central hub in international research collaboration.

Figure 4.

National collaboration network diagram.

3.5. Institutional publications

In total, 39 institutions contributed to English-language publications on TCM nursing techniques for postpartum rehabilitation. Among them, Mashhad University of Medical Sciences published the highest number of papers (n = 5). Statistical analysis revealed that the top 10 institutions with the most publications were all universities (Table 1). In the Chinese-language publications, 345 institutions were identified. Guangxi University of Chinese Medicine had the highest number of papers (n = 21), followed by Shandong University of Traditional Chinese Medicine (n = 20) and the Hospital of Guangzhou University of Chinese Medicine (n = 16). The top 10 institutions were either universities or hospitals specializing in TCM. VOSviewer (v1.6.20) was used to visualize the institutional network in English-language publications. Institutions such as Zhejiang University, the Korea Institute of Oriental Medicine, Peking University, Zhejiang Chinese Medical University, London South Bank University, and the University of Southampton exhibited more extensive external collaborations (Fig. 5A). Similarly, CiteSpace (v6.3.R1) was used to analyze the institutional network in Chinese-language publications. Universities specializing in TCM, such as Guangxi University of Chinese Medicine, Guangzhou University of Chinese Medicine, and Henan University of Traditional Chinese Medicine, engaged in more frequent collaborations (Fig. 5B). However, institutional collaborations remained relatively limited, primarily forming stable regional partnerships between TCM universities and their affiliated hospitals.

Table 1.

Top 10 institutions for English and Chinese publications.

Rank	English publications	Count	Chinese publications	Count
1	Mashhad University of Medical Science	5	Guangxi University of Chinese Medicine	21
2	Shanghai University of Traditional Chinese Medicine	4	Shandong University of Traditional Chinese Medicine	20
3	Zhejiang Chinese Medical University	4	Hospital of Guangzhou University of Chinese Medicine	16
4	Zhejiang University	4	Ruikang Hospital of Guangxi University of Chinese Medicine	13
5	Western Sydney University	4	Beijing University of Chinese Medicine	13
6	China Medical University	3	Jiangsu Hospital of Integrated Chinese and Western Medicine	12
7	Fooyin University	3	Henan University of Chinese Medicine	10
8	Mazandaran University of Medical Sciences	3	Hunan University of Chinese Medicine	10
9	Taipei Medical University	3	Hospital of Hunan University of Chinese Medicine	9
10	Hasanuddin University	3	Guangzhou University of Chinese Medicine	9

Figure 5.

Institutional collaboration network map. (A) English-language publications. (B) Chinese-language publications.

3.6. Author analysis

VOSviewer (v1.6.20) was used to generate a co-occurrence density visualization of the main contributing authors, reflecting the frequency of co-authorship among researchers in the field. Figure 6A shows a total of 16 core authors with at least 2 English-language publications; “Ahmad, Mardiana” and “Ko, Yi-Li” have the largest nodes, indicating their significant contributions. Two primary collaborative author teams were identified (namely, Ahmad and Zhang Shi-Ke) both of which have established core research groups in this area. In the Chinese-language publications, 74 core authors with at least 4 publications were identified. The authors “Tang Guixiang,” “Liu Fang,” “Wang Yuan,” “Chen Pengdian,” “Bei Jianhong,” and “Chen Shuangshuang” had the largest nodes, reflecting their extensive publication records (Fig. 6B). Three primary collaborative author teams emerged; relatively strong internal cooperation was evident within each group. These included the Chen Pengdian, Tang Guixiang, and Wang Yuan teams, all of which have played a pivotal role in advancing research in this field.

Figure 6.

Authors’ collaboration network diagram. (A) English-language publications. (B) Chinese-language publications.

3.7. Keyword co-occurrence

VOSviewer (v1.6.20) was used to construct a keyword co-occurrence network for the included publications. Larger nodes indicated higher keyword frequency, reflecting key research hotspots in this field. Following synonym consolidation of initial 304 English keywords into 285 standardized terms, 28 keywords met the inclusion criterion of more than 3 co-occurrences. English-language literature on postpartum rehabilitation using TCM nursing techniques could be categorized into 5 thematic clusters: postpartum (red), review (green), cesarean section (blue), breastfeeding (yellow), and auricular point (purple) (Fig. 7A). The top 5 keywords in English publications were “cesarean section,” “randomized controlled trial,” “acupuncture,” “breastfeeding,” and “massage” after exclusion of the general term “postpartum.” For Chinese-language publications, 122 of 3318 keywords met the inclusion criterion of more than 15 co-occurrences. These publications could be classified into 6 categories: postpartum (red), uterine involution (green), lactation (pink), feeling (yellow), clinical effect (purple), and cesarean section (blue) (Fig. 7B). The top 5 keywords in Chinese publications were “cesarean section,” “acupoint massage,” “postpartum lactation,” “postpartum urinary retention,” and “breastfeeding” after exclusion of the general terms “postpartum” and “puerpera.”

Figure 7.

Keyword co-occurrence network diagram. (A) English-language publications. (B) Chinese-language publications.

A timeline diagram was used to track research trends over the past decade (2014–2024), revealing the evolution of research hotspots in TCM nursing techniques for postpartum rehabilitation. Figure 8 presents keyword clusters in chronological order; each year is represented as an individual time block. The log-likelihood ratio algorithm was applied to assess the clustering quality, yielding a modularity value (Q) > 0.3, indicating effective clustering, and a silhouette index (S) > 0.7, demonstrating the credibility of the results. For English and Chinese publications, Q values were 0.6325 and 0.417, whereas S values were 0.8761 and 0.7282, respectively, indicating meaningful and reliable clustering. Further analysis of the keyword timeline graphs revealed 6 distinct clusters in both English and Chinese publications. In English publications (Fig. 8A), “depression” appeared within the pelvic floor dysfunction cluster (#0), whereas “bibliometric analysis” (#5) formed an independent category. In Chinese publications (Fig. 8B), acupoint massage was primarily used for breastfeeding-related issues (#0), acupoint application was frequently combined with auricular acupressure (#1), and moxibustion was commonly used to reduce postpartum hemorrhage and promote uterine involution (#2). Additionally, acupoint injection was predominantly used for gastrointestinal function recovery after cesarean section (#5).

Figure 8.

Keywords timeline. (A) English-language publications. (B) Chinese-language publications.

3.8. Keywords with citation bursts

The top 15 keywords with citation bursts in English and Chinese publications were identified using CiteSpace (v6.3.R1) (Fig. 9A and B). The blue line represents the overall time interval, whereas the red line indicates periods of intense keyword citation bursts (Chen et al (2014)). In English publications, “massage,” “moxibustion,” and “auricular acupuncture” emerged as strong citation bursts, with burst intensities of 2.1, 2.02, and 1.97 in 2021, 2018, and 2018, respectively. Recent research trends highlighted “massage,” “pain,” and “management” as prominent topics. In Chinese publications, “thunder fire moxibustion” demonstrated the highest citation burst intensity of 14.53 in 2022. In terms of clinical symptoms, current research hotspots are increasingly focused on “negative emotion,” “sleep quality,” and “pain.”

Figure 9.

Keywords with strongest citation bursts. (A) English-language publications. (B) Chinese-language publications.

4. Discussion

4.1. General information

TCM holds that the pathophysiological mechanisms underlying postpartum health issues are primarily characterized by “dual deficiency and stasis.”^[20,21] The physical exertion of childbirth, significant blood loss, and birth trauma directly deplete Qi and blood, leading to acute “sudden Qi-blood deficiency.” After placental detachment, the impaired expulsion of uterine lochia or exposure to cold can result in “blood stasis obstruction,” whereby insufficient Qi-blood circulation fails to support normal physiological functions and thus exacerbates stasis. Simultaneously, childbirth disrupts visceral functions and increases susceptibility to external pathogens, predisposing postpartum women to various disorders. The present findings demonstrate the potential of TCM nursing technology in addressing these common postpartum health concerns.

This study identified 2788 Chinese publications (2014–2024) on TCM nursing technology in postpartum rehabilitation, representing 9.51% of all domestic TCM nursing technology literature documented by Zhu Weiqin et al^[22] for the period 2013 to 2023. This proportion suggests a satisfactory level of clinical adoption of TCM nursing modalities in obstetric practice. The publication trends over the past decade followed a triphasic trajectory: Initial stability (2014–2016), followed by substantial growth (2017–2019), and gradual stabilization (2020–2024). Research output surged from 2017, peaking in 2019 with 359 publications (12.37% of the total). This increase was temporally associated with 2 key developments: China’s implementation of the universal 2-child policy in 2016, which expanded the maternal population; and the release of the 2017 WHO Global Maternal Care Guidelines, which emphasized early-phase postpartum recovery protocols.^[23] The decline post-2020 may reflect disruptions from the Coronavirus Disease 2019 pandemic, which diverted research focus from postpartum rehabilitation to acute infectious disease management. These factors likely contributed to increased clinical demand and academic interest in optimizing TCM nursing interventions for postnatal recovery.

In parallel, TCM nursing technology has gained recognition as a complementary or alternative medical approach in Western countries, as evidenced by its increasing presence in English-language journals. This trend demonstrates its potential for global development, particularly as the field of Complementary and Alternative Medicine advances through international integration and evidence-based research. Despite the abundance of Chinese-language journals specializing in TCM, high-impact publications in the field of TCM nursing remain scarce. The introduction of strategic initiatives, such as the 52 Priority Disease-Specific TCM Nursing Protocols (National Administration of Traditional Chinese Medicine, 2012),^[22] has substantially expanded scholarly output in this domain. However, the rapid proliferation of studies has raised concerns regarding methodological rigor, indicating the need for improved research quality.

Considering China’s rich medical heritage and historical expertise in TCM, Chinese institutions and researchers have emerged as the primary contributors to global scholarship on TCM nursing technology for postpartum rehabilitation. This dominance reflects the country’s concerted efforts to modernize and preserve its traditional healthcare practices. However, this geographic concentration may introduce regional bias, potentially limiting the generalizability of findings to diverse healthcare systems where cultural acceptance of TCM, postpartum practices, and physiological responses differ. Despite its leadership in the field, research collaboration remains limited, both domestically (between institutions) and internationally. This aligns with broader critiques of TCM research, which highlight the need for increased academic cooperation.^[22,24,25] As the birthplace of TCM, China has a unique opportunity to leverage its cultural and scholarly heritage to foster multinational research partnerships, conduct cross-cultural validation studies, promote academic exchange, and drive evidence-based global integration of TCM systems. Future studies should prioritize cross-cultural clinical trials to assess the adaptability of TCM nursing techniques like acupoint massage or moxibustion in non-Chinese populations. This study identified England as a key player in cross-border TCM research collaborations, demonstrating strong international research capabilities in this area and exemplifying the value of diversified perspectives.

4.2. Research hotspots

In total, 28 of 285 English keywords met the inclusion criterion of more than 3 co-occurrences. The limited number of English-language publications on this topic, combined with inconsistencies in English terminology for TCM nursing technology, likely contributed to this relatively small subset. Analysis of the CNKI database revealed that 122 keywords had a citation frequency exceeding 15, indicating strong research support for various topics within this field.

Keyword co-occurrence analysis identified “cesarean section” as the most frequently cited topic, with high centrality in both English and Chinese publications. Studies indicate that the global cesarean section rate has been rising annually^[26]; the WHO projects that nearly one-third of all births worldwide will be delivered via cesarean section by 2030. The 2019 Enhanced Recovery After Surgery Society’s guidelines for cesarean delivery emphasize patient-centered approaches to optimize postoperative rehabilitation and improve maternal and neonatal outcomes.^[27] TCM nursing technology has demonstrated unique advantages in promoting early recovery after cesarean section. For instance, acupuncture point injection of neostigmine at Zusanli enhances postoperative gastrointestinal recovery by combining drug absorption with meridian pathway stimulation.^[28] Similarly, percutaneous high-frequency electrical stimulation at Neiguan significantly reduces the incidence of intraoperative hypotension during cesarean section.^[29] Additionally, auricular acupressure, using seed stimulation at corresponding points, maintains physiological connections with various body regions, improving postpartum sleep quality and alleviating postoperative nausea and vomiting.^[30,31]

In addition to cesarean section recovery, “breastfeeding” and “postpartum lactation” have emerged as prominent research areas. Increasing evidence suggests that insufficient milk production compromises neonatal nutrition while hindering maternal physiological recovery, potentially increasing the risk of postpartum complications.^[32,33] Acupoint massage has been widely documented as the predominant TCM nursing technology for lactation enhancement; several clinical studies have demonstrated its efficacy in stimulating mammary gland function through meridian regulation.^[34]

4.3. Research frontiers and trends

In term of symptoms, “negative emotion” and “sleep quality” were particularly prominent among the most frequently occurring and central keywords in this field, indicating that these 2 postpartum issues are major research concerns. Studies have demonstrated a strong association between postpartum sleep quality and maternal psychological function; sleep disorders directly contribute to negative emotions and increase the risk of postpartum depression.^[35] The incidence of negative postpartum emotions is high and continues to rise globally, making this a key public health issue affecting both maternal and child health. Currently, treatments for postpartum mood disorders include pharmacotherapy, psychological interventions, and lifestyle modifications, all of which are widely recognized for their efficacy.^[36] However, TCM has an extensive history in the treatment of postpartum emotional disorders, offering a well-established theoretical framework that integrates classical TCM principles with modern medical perspectives. TCM nursing technology has distinct advantages, including robust therapeutic effects, minimal adverse reactions, and high acceptance among postpartum women, leading to increasing academic attention. Among the most commonly applied TCM nursing techniques in postpartum emotional management are TCM emotional nursing through 5-element music therapy, foot fumigation therapy, aromatherapy, acupuncture, and moxibustion.^[37,38] Looking ahead, the application of TCM nursing technology in postpartum emotional regulation should increasingly emphasize preventive strategies, in accordance with the TCM principle of “preventing disease before it arises.” Strengthening early intervention measures may further reduce the incidence of postpartum depression and contribute to improved maternal well-being and family stability.

Regarding treatment modalities, thunder-fire moxibustion, Chinese medicine package therapy, and wrist-ankle acupuncture have emerged as major research frontiers. Thunder-fire moxibustion is a specialized therapeutic technique in TCM nursing technology that integrates herbal medicine with compressed mugwort floss to create medicated cylindrical sticks, typically 3 cm in diameter and 10 cm in length. When applied using suspended moxibustion techniques over targeted acupoints, this intervention generates a localized area of high herbal concentration on the skin surface. Through the combined effects of thermal stimulation and infrared radiation, thunder-fire moxibustion facilitates meridian regulation, enhances blood circulation, and improves microvascular perfusion in peripheral tissues. In postpartum rehabilitation, it has been reported to accelerate lochia discharge,^[39] stimulate lactation,^[40] and reduce the risk of postoperative deep vein thrombosis.^[41] However, existing research primarily examines thunder-fire moxibustion as part of multimodal interventions, rather than as an independent therapeutic approach. This may be attributed to its relatively slow onset of action and the requirement for a prolonged treatment cycle. Future rigorous randomized controlled trials are necessary to establish its independent clinical efficacy. Similarly, Chinese medicine package therapy has gained recognition for its multimodal therapeutic benefits, which are achieved through the synergistic interaction of thermal and botanical effects. The application of herbal compresses enhances pelvic hemodynamics through localized heat stimulation, alleviates uterine contracture via the antispasmodic properties of herbal constituents, facilitates lochia expulsion, and restores systemic Qi-blood homeostasis. Collectively, these mechanisms contribute to the relief of postpartum uterine contraction pain and lumbosacral discomfort, thereby improving maternal recovery.^[42] Due to its demonstrated efficacy, this technique has gained widespread popularity among postpartum women. Wrist-ankle acupuncture is another prominent research focus, representing a refined acupuncture technique that integrates classical meridian theory with modern neuroanatomy. By stimulating distal wrist and ankle dermatomes, wrist-ankle acupuncture induces segmental neuromodulation and optimizes energy flow along specific meridians.^[43] Clinical trials have documented its capacity to reduce post-cesarean pain, as indicated by decreased visual analog scale scores, while also lowering opioid requirements during the postpartum recovery period. Furthermore, this technique has been shown to significantly reduce maternal anxiety indices, thus promoting a smoother overall recovery process.^[44,45] These findings are consistent with the holistic principles of TCM nursing, offering noninvasive, patient-centered approaches that complement conventional postpartum care. Future research should aim to further refine these interventions, integrate them into standardized clinical practice, and explore their broader application in improving maternal health outcomes.

5. Limitations and suggestions

This study had some limitations. First, as a bibliometric analysis, it primarily relied on quantitative methods, which do not allow evaluation of the quality of the included literature. The varying quality of the records may have diminished the credibility of the map analysis because it is solely based on the number of publications and citations, rather than content quality. Second, the predominance of Chinese publications may limit the generalizability of findings to other cultural and healthcare contexts. Future bibliometric analyses should incorporate multi-language databases and international collaborations to enhance geographic diversity. Third, considering that the WOS continuously updates its database, the literature collected during this study may not accurately represent the most current publications. Therefore, the dataset used may not capture all relevant studies, and the actual number of included publications may vary.

6. Conclusions

This study provided a comprehensive and objective analysis of clinical studies on TCM nursing techniques for postpartum rehabilitation published in the WOS and CNKI over the past decade. The findings highlighted the strong research value and promising application prospects of TCM nursing technology in postpartum rehabilitation. Chinese authors and institutions have emerged as key contributors to this field; England has demonstrated strong proficiency in fostering international collaborations. The primary research hotspots in TCM nursing technology for postpartum rehabilitation focused on cesarean section and breastfeeding. Furthermore, frontier topics in this field emphasized the treatment of negative emotions, sleep quality, and the use of specific TCM modalities, such as thunder-fire moxibustion, Chinese medicine package therapy, and wrist-ankle acupuncture. In the future, it will be important to strengthen international cooperation and academic exchange between countries, institutions, and authors to further advance research in this area. Additionally, more rigorous and scientifically robust research designs will be needed to provide high-quality evidence regarding the feasibility of TCM nursing technology in postpartum rehabilitation, ultimately promoting its broader application and integration into postpartum care practices.

Acknowledgments

The authors would like to express their gratitude to Textcheck (http://www.textcheck.com) for the expert linguistic services provided.

Author contributions

Conceptualization: Qingge Li, Ying Jin.

Data curation: Qingge Li, Jin Xu, Yan Chen.

Formal analysis: Qingge Li, Jin Xu, Yan Chen.

Methodology: Qingge Li, Ying Jin.

Project administration: Qingge Li, Jin Xu, Ying Jin.

Visualization: Qingge Li, Jin Xu.

Writing – original draft: Qingge Li, Jin Xu.

Writing – review & editing: Qingge Li, Jin Xu, Ying Jin.