Abstract
BackgroundMoxibustion is an ancient traditional medicine using burning mugworts to stimulate acupuncture points. The aim of this study was to investigate the safety and efficacy of moxibustion for the treatment of constipation using a randomized, sham-controlled, participant-blinded, pilot trial.MethodsTwenty-six participants (identified with either qi (vital energy) deficiency or qi excess syndrome) were randomly divided into either a moxibustion or sham group. Participants were treated with real or sham moxibustion at 4 acupuncture points, ST23 and ST27, bilaterally, 3 times per week for four weeks. The primary outcome was the frequency of defecations; secondary outcomes were the Bristol stool form scale (BSS) and the constipation assessment scale (CAS).ResultsOf the 26 participants that were randomized, 24 completed the study. Defecation frequency, BSS, and CAS showed no difference between the moxibustion and sham groups. The differences were -0.25 (95% CI: -2.08, 1.58, p = 0.78), -1.22 (95% CI: -2.7, 0.26, p = 0.1), 0.91 (95% CI: -1.46, 3.28, p = 0.44) in defecation frequency, BSS, CAS, respectively. The defecation frequency increased from an average of 3.3 to 4.6 times per week in the moxibustion group (1.5[-0.5, 2], p = 0.06) and from 2.7 to 3.7 stools per week in the sham group (1[-1, 2], p = 0.15) after four weeks of treatment. The difference between participants with a deficiency or an excess syndrome, determined based on assessment of sweat, facial features, pain, body energy, and pulse type, was significant in only defecation frequency. The difference was 3.3 (95% CI: 0.41, 6.19, p = 0.03).ConclusionMoxibustion treatment appears safe, but showed no positive effect on constipation. The effectiveness of moxibustion treatment may depend on the syndrome pattern, and further long-term studies with a larger number of subjects are warranted.Trial registrationClinical Research Information Service, KCT0000168
Highlights
Moxibustion is an ancient traditional medicine using burning mugworts to stimulate acupuncture points
The study was conducted in accordance with the Declaration of Helsinki, and written informed consent was obtained from each participant before allocation
Syndrome pattern differentiation of deficiency and excess syndromes As constipation is considered to be caused by either a deficiency or excess of qi in traditional medicine in China and Korea, we developed questionnaires to differentiate between the deficiency and excess syndromes based on a validated previous study [24]
Summary
Moxibustion is an ancient traditional medicine using burning mugworts to stimulate acupuncture points. In Korea, the prevalence is 16.5% for self-reported constipation, 9.2% for functional. Many patients are disappointed by current conventional treatments and seek help from complementary and alternative medicine practitioners [8]. Moxibustion has been widely used in Asian countries as traditional Chinese medicine (TCM). Acupuncture and moxibustion are similar except that their stimulation methods are different. Moxibustion uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points. Moxibustion treatment, though uncommon in Western countries, has been shown to have benefits for pain [9], cancer care [10], and ulcerative colitis [11]
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