Moxibustion Therapy Research Articles

Discussion on prevention and treatment of infectious diseases by using moxibustion for warming yang and strengthening body resistance to eliminate pathogenic cold and qi in ancient and mo-dern literature

Moxibustion therapy has a good therapeutic effect in warming yang, strengthening body resistance to dispel pathogenic cold and qi, thus being able to prevent and treat infectious diseases. There are many records about clinical application of moxibustion to infectious diseases in ancient and modern literature. In the present paper, we expound the specific methods of moxibustion for strengthening the body resistance and preventing infectious diseases and its application in the treatment of miasma, bone steaming disease, cholera, pestis, epidemic hemorrhagic fever and so on, in the records of ancient and modern times, and expound its effectiveness. On this basis, we also proposed the feasibility of moxibustion in the prevention and treatment of COVID-19, a new type of infectious disease currently.

Development and analysis of clinical prediction model of acupuncture and moxibustion treatment for stroke at recovery stage

To develop the clinical prediction model of therapeutic effect in treatment with acupuncture and moxibustion for the patients with stroke at recovery stage under different conditions so as to provide a tool for predicting the therapeutic effect of acupuncture and moxibustion. A total of 1410 patients with stroke at recovery stage were collected from the Third Affiliated Hospital of Zhejiang Chinese Medical University from 2012 to 2019. The relevant data were extracted, i.e. sex, age, time of onset, neurological functional deficit score (NFDS) and acupuncture and moxibustion therapy. The difference of NFDS before and after treatment was adopted to evaluate the therapeutic effect in the patients. Using SPSS26.0 software and CART decision tree analysis, the clinical prediction model was developed. The key variables in the prediction model of therapeutic effect in the patients with stroke at recovery stage under different conditions included age, time of onset, hypertension, cardiac disease, diabetes, TCM diagnosis, hemoglobin (HB), serum homocysteine (HCY) and acupuncture and moxibustion therapy. There were 12 main rules generated by the decision tree model, including 8 rules for predicting the improvements of therapeutic effect and 4 rules for predicting the absence of improvements (i.e. no change and deterioration). The accuracy rates of the model training set and test set were 80.0% and 72.8% respectively, the area under curve (AUC) of ROC was 0.797 and the model identification and classification results were satisfactory. The clinical prediction model developed by CART decision tree analysis is high in accuracy for the prediction of the therapeutic effect in the patients with stroke at recovery stage under different conditions. Based on the therapeutic effect predicted in the hospital visit, the physicians may adopt the corresponding regimens of acupuncture and moxibustion therapy in patients.

Purinergic ATP triggers moxibustion-induced local anti-nociceptive effect on inflammatory pain model

Purinergic signalling adenosine and its A1 receptors have been demonstrated to get involved in the mechanism of acupuncture (needling therapy) analgesia. However, whether purinergic signalling would be responsible for the local analgesic effect of moxibustion therapy, the predominant member in acupuncture family procedures also could trigger analgesic effect on pain diseases, it still remains unclear. In this study, we applied moxibustion to generate analgesic effect on complete Freund’s adjuvant (CFA)-induced inflammatory pain rats and detected the purine released from moxibustioned-acupoint by high-performance liquid chromatography (HPLC) approach. Intramuscular injection of ARL67156 into the acupoint Zusanli (ST36) to inhibit the breakdown of ATP showed the analgesic effect of moxibustion was increased while intramuscular injection of ATPase to speed up ATP hydrolysis caused a reduced moxibustion-induced analgesia. These data implied that purinergic ATP at the location of ST36 acupoint is a potentially beneficial factor for moxibustion-induced analgesia.

Effect of different moxibustion interventions on hepatic histomorphology and PD-1 expression in immunosuppressed rabbits: 不同灸法干预对免疫抑制兔肝脏组织形态学及PD-1表达的影响

Objective To observe the changes in hepatic histomorphology and the differences in the expression of PD-1 after different moxibustion interventions in the immunosuppressed rabbits caused by cyclophosphamide and analyze the intervention effects of different moxibustion therapies.Methods A total of 40 big-ear white rabbits were randomized into 4 groups, i.e. a blank group, an immunosuppressed model group, a moxibustion group and a herbal-paste isolated moxibustion group, 10 rabbits in each one. In the immunosuppressed model group, the moxibustion group and the herbal-paste isolated moxibustion group, the intraperitoneal injection with cyclophosphamide was administered consecutively for 7 days, 60 mg/kg, and then, the immunosuppressed models were prepared. After the models were established successfully, in the moxibustion group and the herbal-paste isolated moxibustion group, moxibustion was administer at “Shénquè (神阙CV 8)” “Guānyuán (关元CV 4)” “Zúsānlĭ (足三里ST 36)” “Píshū (脾俞BL20)” and “Shènshū (肾俞BL23)”, once every other day, 10 times in total. In the blank group and the immunosuppressed model group, the rabbits were restricted on the rabbit platform at the same time periods, without intervention. On the second day after the end of intervention, the animals were weighed and anesthetized, and the livers were extracted. After routine HE staining, the changes of hepatic histomorphology were observed under the microscope and the morphometric analysis was conducted in each group. Besides, PD-1 expression was observed with immunohistochemical method.Result Compared with the blank group, after modeling of each animal in three groups, the body mass decreased obviously (all P < 0.01), the hepatocyte count decreased (all P < 0.01), the inflammatory cellular infiltration area was increased obviously (all P < 0.01), necrosis appeared in hepatic tissue and the positive expression of PD-1 in hepatic tissue was significantly increased (all P < 0.01). After moxibustion intervention, compared with the immunosuppressed model group, the body masses of the animals were increased obviously (P < 0.05, P < 0.01), the hepatocyte count was increased obviously (both P < 0.01), the infiltration area of inflammatory cells decreased significantly (both P < 0.01) and the expression of the PD-1 decreased in the hepatic tissue (both P < 0.05) in both the moxibustion group and the herbal-paste isolated moxibustion group. Compared with the moxibustion group, the animal body mass was higher obviously (P < 0.01), the hepatocyte count was raised apparently (P < 0.01) and the infiltration area of inflammatory cells were reduced obviously (P < 0.05) in the herbal-paste isolated moxibustion group.Conclusion The intervention with different moxibustion therapies improves the condition of body mass reduction and hepatic tissue damage of the immunosuppressed rabbits caused by cyclophosphamide. The effect of herbal-paste isolated moxibustion therapy is better than that of simple moxibustion therapy.

Efficacy of Acupuncture-Related Therapy in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials.

ObjectiveKnee osteoarthritis (KOA) is prevalent in middle-aged and elderly people. This condition negatively affects the quality of life of patients. Although non-steroidal anti-inflammatory drugs (NSAIDs) are often used to relieve symptoms associated with KOA, it is associated with many side effects. Acupuncture and moxibustion therapies have been applied in the treatment of KOA. However, the efficacy of various acupuncture and moxibustion treatments has not been compared.MethodsRandomized controlled trials (RCTs) on the application of acupuncture and moxibustion in the treatment of KOA were searched in English databases and Chinese databases. Data were retrieved from establishment of the database to September 2020. Data analysis was performed using Stata14.0 and GeMTC 0.14.3 softwares.ResultsA total of 40 RCTs involving 3215 patients with KOA were retrieved. Network meta-analysis revealed that the fire needle was superior to western medicine, electro-acupuncture, conventional acupuncture, warm needle and sham acupuncture; warm needle was better than conventional acupuncture and western medicine whereas electro-acupuncture was better than conventional acupuncture in improving pain scores in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Moreover, we found that fire needle and warm needle more effectively improved WOMAC stiffness scores than western medicine and sham moxibustion, whereas electro-acupuncture was superior to western medicine and sham moxibustion in improving WOMAC stiffness scores. Further analysis revealed that fire needle, warm needle and electro-acupuncture were more effective in improving WOMAC joint function scores than conventional acupuncture and western medicine. The fire needle was superior to conventional acupuncture and sham acupuncture, whereas electro-acupuncture was better than western medicine, conventional acupuncture and sham acupuncture in improving visual analogue scale scores.ConclusionThis study shows that fire needle is superior to warm needle and electro-acupuncture, whereas warm needle and electro-acupuncture are better than conventional acupuncture, western medicine, sham moxibustion and sham acupuncture.

Closed-loop neuromodulation technique brings new opportunities and challenges to acupuncture and moxibustion therapies

In recent years, the newly appeared closed-loop neuromodulation technique composed of closed-loop controlled stimulation system and neuromodulation is the product of medicine and inter-disciplines. In medical clinical practice, the idea of closed-loop controlled stimulation can be seen everywhere. When both the patient and acupuncturist achieve the state of "Deqi" simultaneously, it is a kind of feedback adjustment process similar to that of the closed-loop stimulation system. Cross-functional multidisciplinary development is the future trend of medical science progress. The acupuncture-moxibustion discipline can draw lessons from the research experience and achievements of closed-loop neuromodulation techniques to explore the origin of the compatibility of meridians, acupoints, and needling manipulations.

Discussion on current state and research strategies of inter-disciplines of acupuncture-moxibustion and artificial intelligence

At present, the breakthrough of the key techniques of artificial intelligence (AI), including image recognition, deep learning, neural network, Robot technique, etc., greatly promote the development of discipline crossing and medicine. In the present paper, we make an in-depth discussion about the future application of inter-discipline techniques of acupuncture-moxibustion and AI. We think that some of the current instruments have been part of the new acupuncture-moxibustion devices and may have the potential to intersect with the AI discipline. Relying on these existing devices and those of meridian detection, we can obtain relatively objective data, and further conduct meridian-syndrome differentiation and big data collection to possibly realize remote medical treatment. In addition, we may also develop an AI system for studying the underlying mechanisms of acupuncture and moxibustion therapies. Nevertheless, there still exist a lot of problems and challenges in clinical, teaching and scientific researches. It is recommended that the discipline of acupuncture-moxibustion should be intersected with the AI subject and formulate appropriate development strategies, promoting a faster and better development of acupuncturology.

Research progress in the integration of machine learning and acupunctology

Machine learning is a newly emerged discipline. It develops rapidly and has been penetrated into all walks of life and made great achievements in medical field. The introduction of machine learning in the field of acupuncture and moxibustion should fully play the advantages of targeted therapy of acupuncture and moxibustion, optimize the resource allocation of traditional Chinese medicine and accurately serve the clinic rather than only limited to data mining and analysis. In the paper, through the analysis of the relevant literature in recent years, the combination of acupuncture-moxibustion with machine learning was discussed from the aspects of acupoint selection and prescription, clinical teaching application of acupuncture and moxibustion, the prediction on acupuncture curative effect, etc. Moreover, on the base of multidisciplinary intersection and by means of machine learning, the exploration was given on the future direction of acupuncture and moxibustion.

Effectiveness and safety of moxibustion for Parkinson disease: A protocol for systematic review and meta-analysis.

Background:Parkinson disease (PD) is a common neurodegenerative disease among middle-aged and elderly people. Clinically, it is a movement disorder characterized mainly by static tremors, kinesia, myotonia, and postural balance disorder. In recent years, an increasing number of clinical reports on moxibustion therapy for PD have been published. Despite this, no systematic review of moxibustion therapy for PD has been undertaken.Methods:Two reviewers will search the following 7 English and Chinese databases online: the Cochrane Library; PubMed; EMBASE; the China National Knowledge Infrastructure; the Wan Fang databases; the China Science and Technology Journal Database; and the Chinese Biomedical Literature Database. Reviewers will search each electronic database for studies published from journal inception to May 2021. Two reviewers will independently conduct clinical study inclusion, data extraction, and risk bias assessment. Any differences in the above process will be resolved through discussion with a third reviewer. If the data are sufficient, RevMan software 5.3 (Cochrane Community, London, UK) will be used for the meta-analysis of the extracted data.Results:In this systematic review, the effectiveness and safety of moxibustion therapy in PD treatment will be evaluated.Conclusion:This systematic review may provide further evidence to encourage clinicians to use moxibustion in the treatment of PD.INPLASY registration number:INPLASY202140097

Effect of electroacupuncture combined with ginger-isolated moxibustion on endometrial receptivity in infertile patients with polycystic ovarian syndrome: 电针联合隔姜灸对多囊卵巢综合征不孕患者子宫内膜容受性的影响

ObjectiveTo observe the effect of the combined therapy of electroacupuncture (EA) and ginger-isolated moxibustion on endometrial receptivity in the patients with polycystic ovarian syndrome (PCOS). MethodsA total of 70 subjects of PCOS were randomized into two groups, 35 cases in each one. In the western medication group, letrozole and human chorionic gonadotropin (HCG) were administered. In the combined therapy group, on the base of the treatment as the western medication group, the artificial cycle therapy with EA and ginger-isolated moxibustion was provided. The treatment duration was 3 menstrual cycles in two groups. After treated for 3 menstrual cycles, the symptom score of traditional Chinese medicine (TCM), endometrial thickness, the number of ovulation cycle, endometrial morphology, bilateral uterine artery pulsatility index (PI), resistance index (RI), the sum of peak systolic velocity/end diastolic velocity (S/D) and pregnancy were compared in the patients between two groups. Results(1) After treatment, the endometrial thickness was better (0.21 ± ± 0.13 vs 0.14 ± 0.08, P < 0.01), TCM symptom score reducing range was larger (5.00 ± 2.24 vs 0.52 ± 1.66, P < 0.01), the reducing degrees of bilateral uterine artery PI, RI and S/D sum were better (0.62 ± 0.26 vs 0.04 ± 0.15, 0.08 ± 0.05 vs 0.01 ± 0.05, 0.61 ± 0.33 vs 0.07 ± 0.17, 0.11 ± 0.05 vs 0.01 ± 0.05, 4.80 ± 1.14 vs 0.15 ± 0.89, all P < 0.01) in the combined therapy group respectively as compared with the western medication group. After treatment, the number of ovulation cycle and the proportion of A + B type of endometrial morphological were higher in the combined therapy group (2.09 ± 0.78 vs 1.27 ± 0.84, 87.5% vs 60.61%, P < 0.01, P < 0.05) as compared with the western medication group respectively. (2) The clinical pregnancy rate was 56.25% in the combined therapy group, better than 30.30% in the western medication group (P < 0.05). The early abortion rate was 10.53% in the combined therapy group, lower than 50.00% in the western medication group (P < 0.05). ConclusionThe combined treatment of electroacupuncture and ginger-isolated moxibustion with western medication effectively improves endometrial receptivity, increases clinical pregnancy rate and reduces early abortion rate in the patients with PCOS.

A Patient with Guillain-Barre Syndrome Treated with Combined Korean Medicine Treatments

A patient diagnosed with Guillain-Barre syndrome (GBS) suffering from numbness in the toes and fingers, paralysis in the face, and back pain received intravenous immunoglobulin on December 28, 2019. Without an improvement in symptoms the patient was admitted to a Korean medicine hospital on January 1, 2020 to receive combined Korean medicine treatment including herbal medicine (Sipjeondaebo-tanggami and Hyangbujasunkipalmul-tang), acupuncture treatment, moxibustion, cupping treatment, and physical therapy. Treatment was administered over 51 days, of which 17 days were during hospitalization. Paralysis of facial muscle, and numbness in fingers and toes were evaluated using the Yanagihara score and numeric rating scale (NRS) score, respectively. Facial paralysis improved (21 to 40 based on Yanagihara score) and paresthesia of the hands and feet disappeared (NRS score 6-7 to NRS score 0). There were no side effects or sequela. This study suggested combined Korean medicine treatment may be effective for the treatment of GBS.

Moxibustion Ameliorates Ovarian Reserve in Rats by Mediating Nrf2/HO-1/NLRP3 Anti-Inflammatory Pathway.

Diminished ovarian reserve (DOR) is an increasingly emerging reproductive disorder that disturbs reproductive-aged women, which is closely linked with inflammation. In clinic, moxibustion has already been applied for reproductive problems. In the present study, we examined the involvement of inflammation in DOR and investigated the effect of moxibustion for its anti-inflammatory activities. Methods. DOR rat model was established using tripterygium glycosides A tablets (TGs) suspension by intragastric administration and was then treated with either moxibustion or hormone replacement therapy (HRT), respectively. Estrus cycles were observed through vaginal cytology. Ovarian morphological alterations were observed by HE staining. The serum levels of follicle-stimulating hormone (FSH), estradiol (E2), anti-Müllerian hormone (AMH), tumor necrosis factor alpha (TNF-α), and interleukin-10 (IL-10) were measured through ELISA. The expression levels of Nrf2, HO-1, and NLRP3 were detected using immunohistochemistry. Nrf2, HO-1, and NLRP3 mRNA were examined by RT-PCR. Results. Moxibustion improved estrus cycles, FSH, E2, and AMH levels relative to DOR rats as well as HRT, while also inhibiting ovarian tissue injury. Anti-inflammatory cytokine IL-10 in peripheral blood was upregulated, and proinflammatory factor TNF-α was decreased after treatment with moxibustion. Moxibustion enhanced the expression of mRNA and protein of nuclear factor erythroid 2-related factor (Nrf2) and heme oxygenase-1 (HO-1); in the mean time, nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) was suppressed. Conclusions. We demonstrated that moxibustion could ameliorate the ovarian reserve in rats induced by TGs. Overall, the effect of moxibustion was comparable to that of HRT. The underlying mechanism could be attributed to the anti-inflammatory effects of moxibustion, which suppressed NLRP3 activation by upregulating Nrf2/HO-1 signaling pathway.

Correction of Breech Presentation with Moxibustion and Acupuncture: A Systematic Review and Meta-Analysis.

Acupuncture-type interventions (such as moxibustion and acupuncture) at Bladder 67 (BL67, Zhiyin point) have been proposed to have positive effects on breech presentation. The aim of this systematic review and meta-analysis was to evaluate the effectiveness and safety of moxibustion and acupuncture in correcting breech presentation. We searched PubMed, MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Electronic Periodical Services (CEPS), and databases at ClinicalTrials.gov to identify relevant randomized controlled trials (RCTs). In this study, sixteen RCTs involving 2555 participants were included. Compared to control, moxibustion significantly increased cephalic presentation at birth (RR = 1.39; 95% CI = 1.21–1.58). Moxibustion also seemed to elicit better clinical outcomes in the Asian population (RR = 1.42; 95% CI = 1.21–1.67) than in the non-Asian population (RR = 1.20; 95% CI = 1.01–1.43). The effects of acupuncture on correcting breech presentation after sensitivity analysis were inconsistent relative to control. The effect of moxibustion plus acupuncture was synergistic for correcting breech presentation (RR = 1.53; 95% CI = 1.26–1.86) in one RCT. Our findings suggest that moxibustion therapy has positive effects on correcting breech presentation, especially in the Asian population.

Ultrasonic device developed for non-invasive moxibustion therapy

BackgroundRecently, some adverse effects of moxibustion has been reported such as burns, smoke, allergies, and so on. To overcome the adverse effects of traditional moxibustion, an ultrasonic moxibustion device (UMD) was designed, simulated, fabricated, and tested. The objective of this study is to provide detailed information about the main design parameters, simulation outcome, and performance-test results. MethodsThe main components of the UMD are a 1-MHz ultrasonic transducer (UT) with concave lens, and its applicator. The acoustic pressure and temperature distribution of the UT was simulated and described graphically using COMSOL software, which is based on the finite element method (FEM). Experimental verification of the temperature distribution was performed on the skin of pork. The temperature-change profiles of pork in relation to increase of therapy time were obtained at an unfocused point (2 mm) and at a focal distance of 13 mm. For the performance test, moxibustion therapy was conducted on the abdominal skin of mice for 120 min using the new UMD and its histological images were acquired to analyze the skin-tissue damage. ResultsThe FEM simulation of temperature distribution and acoustic pressure agreed with the experimental outcome. Histological images showed that there was no skin-tissue damage to the mouse abdomens after therapy. The results clearly show that the newly developed UMD can overcome the disadvantages of traditional moxibustion therapy and achieve the proposed design parameters. ConclusionThe FEM simulation and performance tests provided valuable information about developing future UMDs. In addition, its performance can be compared with traditional moxibustion therapy for future study.

Clinical research of postpartum pantalgia treated with individualized moxibustion: 个体化灸法治疗产后身痛的临床研究

ObjectiveTo evaluate the clinical therapeutic effect and safety of individualized moxibustion in treatment of postpartum pantalgia. MethodsA total of 99 patients with postpartum pantalgia were divided into three group at the ratio of 1: 1: 1 according to random number table, i.e. an individualized moxibustion group, a quantitative moxibustion group and a voltaren group. The same acupoints were selected in the individualized moxibustion group and the quantitative moxibustion group. With the patient in supine, Zhōngwăn (中脘CV12),Guānyuán (关元CV4), bilateral Tiānshū (天枢ST25), bilateral Xuèhăi (血海SP10), bilateral Yánglíngquán (阳陵泉GB34), bilateral Zúsānlĭ (足三里ST36) and bilateral Sānyīnjiāo (三阴交SP6) were selected. With the patient in prone, Dàzhuī (大椎GV14), bilateral Géshū (膈俞BL17), bilateral Píshū(脾俞BL20), bilateral Shènshū (肾俞BL23), Mìngmén 命门(GV4), bilateral Wĕizhōng (委中BL40) and bilateral Yŏngquán (涌泉KI1) were selected. In the individualized moxibustion group, the moxibusion dose was determined by patient's constitution and conditions as well as no occurrence of dry throat, thirst and local skin lesion. In the quantitative moxibustion group, the moxibustion dose was fixed as 1 cone at each acupoint in treatment. In these two groups, the treatment was given once every two days, three times a week and the treatment for 2 weeks was as 1 course. Totally, 2 courses of treatment were required. In the voltaren group, voltaren ointment was used externally at the pain area, once a day, for 4 weeks totally. Separately, before treatment, at the end of treatment course and in follow-up, the symptom score of traditional Chinese medicine (TCM), pain score of visual analogue scale (VAS) and patient's treatment satisfaction score were observed in the patients of the three groups. ResultsIn comparison within group, TCM symptom score, VAS score and the treatment satisfaction score at the end of treatment were all reduced obviously as compared with those before treatment in each of the three groups (P < 0.05). In 4, 12 and 24 weeks of followup after treatment, the differences in these data were not significant as compared with those at the end of treatment in the individualized moxibustion group and the quantitative moxibustion group respectively (all P > 0.05). In the voltaren group, these data were not different as compared with those at the end of treatment in 4 weeks of follow-up (all P > 0.05), but these data were all increased as compared with those at the end of treatment in 12 and 24 weeks of follow-up (all P < 0.05). In comparison among three groups, at the end of treatment and in 4, 12 and 24 weeks of followup, the above-mentioned three therapeutic effect indicators were all different significantly (all P < 0.05). In comparison between two groups, in the individualized moxibustion group, TCM symptom score, VAS score and the patient's treatment satisfaction score were all lower than those in the quantitative moxibustion group at the end of treatment and at each time point of follow-up successively, indicating the significant differences (all P < 0.05). ConclusionIndividualized moxibustion and quantitative moxibustion improve the short-term and long-term therapeutic effect on postpartum pantalgia as compared with the external application of voltaren ointment. The therapeutic effect and patient's satisfaction of individualized moxibustion for replenishing kidney and nourishing blood are better than the quantitative moxibustion. The individualized moxibustion therapy for replenishing kidney and nourishing blood achieves a satisfactory effect on postpartum pantalgia and is excelled to voltaren ointment that is strongly recommended in modern medicine. Individualized moxibustion is an external therapy of TCM with optimal short-term and long-term therapeutic effect and reliable safety. Hence, it deserves to be promoted in practice.

Moxibustion therapy for treating patients with postpartum urinary retention: A protocol for systematic review and meta-analysis.

Background:Postpartum urinary retention (PUR) is one of the most common complications after parturition which affect women's recovery after childbirth. Many clinical trials have shown that moxibustion, a traditional Chinese medicine therapy, is effective in treating PUR. But its effectiveness has not been evaluated scientifically and systematically. Therefore, this review aims to evaluate the safety and effectiveness of moxibustion therapy in treating patients with PUR.Methods:We will search the following electronic databases, regardless of publication status and languages, from their respective inception dates to February 2021: the Cochrane Central Register of Controlled Trails, Pubmed, EMBASE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database. Clinical randomized controlled trials (RCTs) related to moxibustion therapy for treating PUR will be included. Study selection, data collection, and quality assessment will be independently conducted by 2 researchers. For data synthesis, we will select either the fixed-effects or random-effects model according to heterogeneity assessment. Cure rates and postvoid residual volume (PVRV) will be the primary outcomes. The total effective rate and first urination time will be the second outcomes. Review Manager Software (RevMan) V.5.3 will be used if it is appropriate for meta-analysis. Otherwise, a systematic narrative synthesis will be conducted. The results will be presented as risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and weight mean difference (WMD) or standard mean difference (SMD) 95% CI for continuous data.Trial registration number:INPLASY 202140037.

Moxibustion for diarrhea in children: A protocol for systematic review and meta-analysis.

Background:Infantile Diarrhea is a common and frequent digestive tract disease in children. The causes of this disease are relatively complex and the onset time is relatively long. At present, there is no specific treatment method in Western medicine. Moxibustion is a simple and painless external treatment. However, due to the lack of high-quality evidence to support the effectiveness and safety of moxibustion therapy for pediatric diarrhea. Therefore, the purpose of this study is to verify the effectiveness and safety of moxibustion in the treatment of pediatric diarrhea.Methods:We will use PubMed, Cochrane Library, Wan Fang Database, Web of Science, China National Knowledge Infrastructure Database, Chinese Science Journal Database, China Biomedical Literature Database to carry out a progressive search of diseases. The study will be screened according to eligibility criteria, and quality of the study will be assessed by using the Cochrane Risk of Bias Tool.Results:Through this study, we will systematically evaluate the effectiveness and safety of moxibustion in the treatment of pediatric diarrhea.Conclusion:The results of this study will provide reliable evidence of the safety and effectiveness of moxibustion in the treatment of infantile diarrhea, and provide a therapeutic basis for the future clinical application.Ethics and dissemination:Since this paper does not involve ethical issues, it does not need to pass the review of the ethics committee. It can only collect relevant literature and study.INPLASY Registration number:INPLASY202130091

Effect of moxibustion and acupuncture on gastric mucosal cell apoptosis and expression of NF-κB, Bcl-2 in chronic atrophic gastritis rats

To observe the effect of moxibustion and acupuncture on apoptosis in gastric mucosal cell and expression of NF-κB, Bcl-2 in chronic atrophic gastritis (CAG) rats, so as to explore its mechanisms underlying improvement of CAG. Forty-eight male SD rats were randomly divided into normal, model, moxibustion and acupuncture groups, with 12 rats in each group. The CAG model was established by gavage of N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) solution and irregular diet for 12 weeks. Moxibustion or acupuncture was applied to "Zusanli" (ST36) and "Zhongwan" (CV12) for 15 min, once daily for two weeks in the moxibustion or acupuncture group. The histopathological changes of the gastric mucosa were observed by HE staining. The apoptosis index of gastric mucosa was measured by TUNEL method. The gene expression levels of NF-κB and Bcl-2 were detected by real-time PCR. After modeling, the color of gastric mucosa was pale and dark, with low folds and significant bleeding points. The glands in lamina propria were atrophied, arranged disorderly, and the numbers were significantly reduced, with inflammatory cells infiltrated. Those histopathological changes were evidently milder in the moxibustion and acupuncture groups. Compared with the normal group, the apoptosis index, NF-κB and Bcl-2 gene expression of the model group were significantly increased (P<0.01). After the treatment, the apoptosis index, NF-κB and Bcl-2 gene expression were significantly reduced in the moxibustion and acupuncture groups (P<0.05，P<0.01). The NF-κB expression was lower in the acupuncture group than that of moxibustion group (P<0.01). Moxibustion and acupuncture therapy can improve the injury of gastric mucosa in CAG rats, which may be associated with its function in down-regulating the expression of NF-κB and Bcl-2 genes in the gastric mucosa.

Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial

BackgroundThe first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD. MethodsThirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment. ResultsThe primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067). ConclusionA clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD.

The efficacy of moxibustion and acupuncture therapy for ankylosing spondylitis: A protocol for an overview of systematic reviews and meta-analysis.

Background:Ankylosing spondylitis is a complex and progressive autoimmune inflammatory disease with a worldwide prevalence ranging up to 0.9%. Several systematic reviews and meta-analyses of traditional Chinese medicine alternative therapies, such as acupuncture or moxibustion, have demonstrated the effectiveness of moxibustion and acupuncture in the treatment of ankylosing spondylitis. However, there is no relevant literature to comprehensively evaluate the evidence. The purpose of this overview is to synthesize and evaluate the reliability of evidence generated in the systematic review (SR) and meta-analysis of moxibustion and acupuncture as a primary or complementary therapy for patients with ankylosing spondylitis.Methods:PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database were searched for systematic reviews and meta-analysis that review the efficacy of acupuncture or moxibustion as the primary treatment for patients with Ankylosing Spondylitis. The literature published before August 2020 will be selected. Additionally, the relevant SRs and meta-analyses that unpublished or ongoing will be searched in PROSPERO and INPLASY. The methodological guidelines for overviews will be used to review and extract data by 2 reviewers, and their will do it independently. Methodology quality will be analyzed by the assessment of multiple systematic reviews-2and the risk of bias by POBIS. For the included studies, we will adopt the following results as primary evaluation indicators: effective rate, visual analogue scale and bath AS disease activity index. Reviewers will assess the certainty of evidence by Grading of Recommendations Assessment, Development and Evaluation.Results:The results will be published in a peer-reviewed journal.Conclusion:This overview will provide comprehensive evidence of moxibustion and acupuncture for patients with Ankylosing Spondylitis.