Review Article

The Effectiveness of Moxibustion: An Overview During 10 Years

Table 1

Characteristics and findings of included studies ( ).

Author, year, CounDisorders (Quality*)Intervention, N (analyzed), Freq, DurControl, N (analyzed)Co-interventionAuthor's findingsReviewer's analysis
OutcomesResultsEffective rate (mox versus con, n/N)**, P value***, RR [95% CI]Classification score

I-B. Certain infectious and parasitic diseases

Zhang [26] 2007, CnHerpes zoster (2)Mox (Cd), 38, 1/day, 10 daysNT, 34Acu(1) Effective rate (symptom) (2) Effect-producing time (pain and symptom, resp.)(1) (2) Each 28/38 versus 15/34, 1.67[1.09, 2.55]P

II-C. Neoplasms

Liu [27, 28], 2001, 2002, CnMid-late stage malignant tumor (2)Mox (S), 30(20), NANT, 35(27)Chemo + Herba(1) Therapeutic effect (2) No. of leucocyte and lymphocyte (3) T-lymphocyte subset (4) Normalized cases of plasma fibrinogen (5) Karnofsky score (6) Quality of life(1, 2, 3) NA (4, 5) (6) NS except pain ( )4/30 versus 5/35, 0.93[0.28, 3.16]NEU
Chen [29] 2000, CnNasopharyngeal carcinoma (NPC) (2)Mox (Ci), 28, 1/day, 1monNT, 28Radio(1) Remission rate (tumor size) (2) Toxic and side effects occurrence (3) 5-year local control rate of NPC and cervical lymph node (4) 5-year survival and metastasis rate (5) MDA, MMS, -SH and SOD activity in blood(1, 3, 4) NS (2) (5) MMS, -SH: , MDA, SOD: 23/28 versus 21/28, 1.10 [0.83, 1.44]NEU

III-D. Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism

Zhao [30] 2007, CnLeukopenia induced by chemotherapy (4)Mox (Ci), 114(113), 1/day, 10 daysHerb, 114 (108)(1) Cured rate and effective rate (No. of leucocyte) (2) Physical strength (zubrod-ECOG-WHO) and the gastrointestinal toxic effects according to WHO grading criteia (nausea, vomiting, diarrhea and constipation) (3) Side effects: functions of the heart and lung and kidney induced chemotherapy (the toxic effects according to WHO grading criteria)(1) Each (2) (3) NS95/113 versus 38/108, 2.39 [1.83, 3.12]ND

IV-E. Endocrine, nutritional and metabolic diseases

Liao [31] 2007, CnDiabetes (2)A: Mox (S), 24 B: Mox (S), 26, 2/day, 10 3 daysC: Acu, 29 C: NT, 29Acu(1) Effective rate (2) Cured and markedly effective rate, symptom, FBG, 24 hour urinal glucose, glycosylated hemoglobin, TC, TG, HDL and LDL(1) NS (2) A versus C (NS) B versus C ( )A versus C: 7/24 versus 9/29, 0.94 [0.41, 2.15] B versus C: 12/26 versus 9/29, 1.49 [0.75, 2.94]NDND
Gao [32] 2007a, CnAging (0)Mox (Ci), 30, 2/wk, 2 monA: Acu, 21 B: Vit E, 20(1) Effective rate (symptom) (2) Symptomatic score (type of kidney deficiency) (3) Serum SOD activities and MDA contents(1) (versus A), (versus B) (2) (versus A, B) (3) (versus A, B)A: 14/30 versus 3/21, 3.27 [1.07, 9.96] B: 14/30 versus 1/20, 9.33 [1.33, 65.49]NDP
Li [33] 2005a, CnHyperlipidemia (1)Mox (St), 80, 1/day, 30 × 3 daysNT, 80Diet(1) Hypercholesterolemia subgroup (each ): TC (2) Combined hyperlipidemia subgroup (each ): TC (3) Hypertriglyceremia subgroup (each ): TG (4) Hypo-HDL cholesterolemia subgroup (each ): HDLEach NAP

VI-G. Diseases of the nervous system

Zhao [34] 2008, CnDiabetic peripheral neuropathy (2)Mox (S), 20, 1/2 days, 10 × 2 timesA: Acu, 20 B: Med, 20(1) Symptom score and total effective rate (symptom) (2) FBG, HbA1c (3) Hemorheological indexes (a) Whole blood viscosity (b) Capillary blood viscosity (c) Hematocrit (4) ET, NO, MDA(1, 2) NS (versus A), (versus B) (3), (1) NS (versus A), (versus B) (2), (3) NS (versus A, B) (4) each NS (versus A) and , 0.05, NS (versus B)A: 10/20 versus 9/20, 1.11 [0.58, 2.14] B: 10/20 versus 7/20, 1.43 [0.68, 3.00]NDND
Tian [35] 2006, CnHerpes simplex virus facial neuritis (4)Mox (S-tube), 80(78), 1/day, 6 × 8 timesMox (S), 80(79)Acu(1) Total effective rate (symptom, HBS and FDI) (2) HBS (3) FDI(1, 2) (3) (FDIs), NS (FDIp)51/78 versus 35/79, 1.48 [1.10, 1.98]ND
Zhang [36] 2005, CnParkinson's disease (0)Mox (Ci), 54, 1/2 days, 15 × 2 timesNT, 36Med(1) Total effective rate (UPDRS) (2) The modified UPDRS score(1, 2) 21/54 versus 6/36, 2.33 [1.04, 5.21]P
Gao [37] 2005, CnFacial paralysis (0)Mox (S), 47, 1/day, 30 daysNT, 40EA + Medc + Vit BTotal effective rate (symptom) 38/47 versus 25/40, 1.29 [0.98, 1.71]ND

VII, VIII-H. Diseases of the eye, adnexa, ear and mastoid process

Zhang [38] 2008, CnVertigo (2)Mox (TF, Cd, Ci), 66, 4 × 3 daysMox (Cd), 51(1) Total effective rate (symptom) (2) Total effective rate according to pattern identification (3) Vertigo symptom rating score(1, 3) (2) NA30/66 versus 17/51, 1.36 [0.85, 2.18]ND

IX-I. Diseases of the circulatory system

Chen [39] 2006, CnIschemic apoplexy (0)Mox (Cd), 14, 1/day, 20 daysNT, 14Routine care(1) Change of cerebrovascular functions by TCD (2) Clinical effect by nervous function detect(1, 2) NAND
Moon [40] 2003, KrStroke (1)Mox (Ci), 10, 1/2 days, 15 daysA: EA, 15 B: NT, 10Acu(1) Change of MAS according to treatment period (2) Correlation between MAS and treatment period(1) NA (2) NANANDND

X-J. Diseases of the respiratory system

Yang, [41] 2008, CnPerennial allergic rhinitis (2)Mox (S), 60, 1/day, 10 daysMedd, 60(1) Total effective rate after treatment and 3 mon later (symptom) (2) Clinical symptoms (tickle of nose, sneezing, snivel, congestion)(1) and (2) each 23/60 versus 11/60, 2.09[1.12,3.90]P
Li [42] 2005b, CnAsthma of lung deficiency type (2)Mox (Cd), 37, 1–2/day, 7 × 3 daysAcu, 35(1) Total effective rate (symptom) (2) Clinical symptoms (3) Pulmonary function (FVC, FEV1 and FEF0.25–0.75) (4) Each content of Ig and C3(1) NS (2, 3, 4) each NA18/37 versus 11/35, 1.55[0.86,2.79]ND
Lai [43] 2001, CnAllergic asthma (1)Mox (N), 121, 1/wk, 4 wkDrug acupoint application, 88(1) Total effective rate after treatment and 6 mon (symptom) (2) Total effective rate according to pattern identification (a) Lung heat and kidney yin deficiency (b) Lung cold, lung qi deficiency and kidney yang deficiency(1) Co > Ex: and NS (2) (a) (Co > Ex) (b) NSAfter treatment 52/121 versus 51/88, 0.74 [0.57, 0.97] After 6 mon 38/95 versus 32/74, 0.93 [0.65, 1.32]ND
Long [44] 2001, CnInfantile repeated respiratory tract infection (1)Mox (S), 46, 5/wk, 1 monTransfer factor, 40(1) Effective rate (symptom) (2) Each level of IgG, IgA and IgM (n of each group = 24)(1) (2) 34/46 versus 16/40, 1.85 [1.22, 2.80]P

XI-K. Diseases of the digestive system

Chui [45] 2008, CnInfantile autumn diarrhea (2)Mox (Ci), 683 × 2 daysMede, 68(1) Total effective rate and effective rate (symptom) (2) The mean of symptoms-stopping time (3) Negative conversion rate of HRV Antigen after 72 hr(1) each (2) (fever and diarrhea), NS (nausea) (3) 54/68 versus 24/68, 2.25 [1.60, 3.17]P
Gao [46] 2007b, CnChronic atrophic gastritis (1)Mox (S), 30 2 monNT, 30Acu(1) Total effective rate (symptom) (2) Pathological effect (3) Level of serum gastrin(1, 3) (2) NA13/30 versus 15/30, 0.87 [0.50, 1.49]ND
Wang [47] 2006, CnUlcerative colitis (0)Mox (Ci), 30 1/day, 10 × 3 daysMedf, 30(1) Effective rate and total effective rate (symptom) (2) Ig G, Ig A and Ig M content (3) Peripheral blood T-cell and NK cell(1) and  .01 (2) each , NS and NS (3) NA22/30 versus 9/30, 2.44 [1.36, 4.40]P
Yu [48] 2002, CnDiarrhea (1)Mox (Cd), 56 1/2 days, 1 monHerb, 56(1) Total effective rate (symptom) (2) Salivary amylase (3) Middle molecular substances in serum(1, 3) (2) 32/56 versus 25/56, 1.28 [0.88, 1.85]ND
Lin [49] 2000, CnPostoperative gastric functional disorder (1)Mox (Ci), 20 7 daysA: Herb, 20 B: Medg, 20Change of preoperative and postoperative EGGNSNANDNEU
Wu [50] 2000, CnUlcerative colitis (1)Mox (Ci), 30 1/day, 12 × 5 daysMedh, 16(1) Cure rate (symptom and colomoscopy result) (2) Change of colonic mucosal histopathology and mucin (n = 13)(1) P < .01 (2) NA17/30 versus 5/16, 1.81 [0.82, 4.00]ND

XII-L. Diseases of the skin and subcutaneous tissue

Diao [51] 2007, CnNeurodermatitis (2)Mox (Ci), 30 1/2 days, 1 monMedi, 30(1) Total effective rate (symptom) after 2 wk, 3 wk and final treatment (2) Relapse rate during treatment period(1) each , and (2) 27/30 versus 20/30, 1.35 [1.02, 1.79]ND
Lao [52] 2005, CnChloasma (2),Mox (Ci), 60 2/wk, 8 × 3 timesNT, 46AcuTotal effective rate (symptom) 31/60 versus 21/46, 1.13 [0.76, 1.69]ND

XIII-M. Diseases of the musculoskeletal system and connective tissue

Chen [53] 2008, CnMyofascial pain syndrome (3)Mox (S), 57 1/day, 10 timesAcu + Cupping + TDP, 50(1) PRI, VAS and PPI of McGill pain questionnaire (2) Cured or markedly effective rate and total effective rate (symptom and PRI, VAS, PPI of McGill pain questionnaire)(1) Each (2) and NS49/57 versus 12/50, 3.58 [2.16, 5.93]ND
Sun, [54] 2008a, CnKnee osteoarthritis (3)Mox (Ci), NA(29) 1/day, 10 × 2 timesMedj, NA(27)(1) Improvement in the symptom after 5, 10, 20 times and 2 mon later (2) Cured or markedly effective rate (after treatment and 2 mon later) (symptom)(1) , NS, NS and (2) NS and After treatment (no. of knees) 26/41 versus 19/39, 1.30 [0.88, 1.94] After 2 mon later 23/41 versus 13/39, 1.68 [1.00, 2.83]NEU
Li, [55] 2008, CnKnee osteoarthritis (1)Mox (S), 31(30) 6/wk, 4 wkHerbk, 31(30)(1) Cured rate and effective rate (symptom) (2) VAS, ISOA scale and effect-producing time(1) and NS (2) each 27/30 versus 18/30, 1.50 [1.09, 2.06]ND
Jia [56] 2006, CnAnkylosing spondylitis (1)Mox(Ci), 30 1/2 days, 2 × 3 monA: Acu, 30 B: NT, 30MTX + Medl(1) Total effect rate (symptom, ESR and CRP) (2) Cured or markedly effective rate (3) The days needed for reaching the clinical remission and remarked effect (4) Relapse rate after 1 year (5) Improvement in the symptoms and signs (a) Morning stiffness, swollen and painful peripheral joints and chest expansion (b) Finger-ground distance, sacroiliitis index, schober test and occipital wall test (6) Change in ESR and CRP(1) NS (versus A), (versus B) (2,3) NA (versus A), (versus B) (4) each 0, 0 and 30 (5) (a) NS (versus B) (b) (versus B) (6) NAA: 25/30 versus 24/30, 1.04 [0.82, 1.32] B: 25/30 versus 18/30, 1.39 [1.00, 1.94]NDND
Li [57] 2006a, CnRheumatoid arthritis (2)Mox (S), 30 5/wk, 3 monNT, 30Medm(1) Improved rate, markedly effective rate, effective rate, ACR 50% effective rate and the ratio withdrawing NSAIDs (2) Symptoms (a) Swelling joint and grasping power (b) Body pain, tenderness of joint and lasting time of the grasping power (3) HAQ (4) ESR, CRP and RF (5) Rate of adverse reaction(1) NS, NS, , and (2) (a) (b) NS (3) NS (4) , NS and NS (5) 22/30 versus 14/30, 1.57 [1.01, 2.44]ND
Zeng [58] 2006, CnCervical vertigo (1)Mox (Ci), 40 10 × 2 daysAcu, 38Cured rate and total effective rate (symptom, blood supply and recurrence after 3 mon)Each 39/40 versus 28/38, 1.32 [1.09, 1.61]ND
Zhuang[59] 2000, CnCervical spondylosis (1)Mox (Cd), 21 10 timesNT, 19AcuCured or markedly effective rate 18/21 versus 11/19, 1.48 [0.97, 2.26]ND

XIV-N. Diseases of the genitourinary system

Sun [60] 2008b, CnEnd stage renal failure in hemodialysis (3)Mox (Ci), 37 2–3/wk, 4 × 3 wkNT, 34Hemodialysis + MedKidney Disease Quality of life Short Form (KDQOL) : only 3 items (Dialysis staff encouragement, Role-Emotional and General health) among the 20 itemsNANEU
Yun [61] 2007, KrPost-stroke urinary symptoms (4)Mox (Cd), 21(20) 5/10 daysNT, 20(19)Herb + Acu(1) IPSS (frequency, weak stream, quality life scale, obstructive score, irritative score and total IPSS score) (2) QOL index (3) Urinary symptoms improvement according to the severity (4) Barthel Index(1) (2) NS (3) (mild, moderate), NS (severe) (4) NSNAP
Liu [62] 2006, CnPost-stroke urinary symptoms (2)Mox (Ci), 41(32), 5/wk, 3 wkNT, 41(30)Acu(1) The therapeutic effects (mean of urinary times every day and mean times to be asked to awaken for the nursing personnel at night) (2) Mean times of urgent urinary incontinence at day for the patient and cases-times of urinary incontinence of the patient at night (3) Increasing degree of urinary incontinence(1) Each (2, 3) NANAP
Li [63] 2006b, CnPrimary dysmenorrhea (2)Mox (Ci), 78, 7(max)/cycle, 3 monHerbn, 60(1) Cured rate and total effective rate (2) Index of therapeutic effect(1, 2) Each 71/78 versus 45/60, 1.21 [1.03, 1.43]ND
Shin [64] 2006, KrPain and coldness on hysterectomy (2)Mox (Ci), 5, 1/day, 5wkAcu, 5(1) Change of body temperature (2) Change in pain(1) NS (2) NANAND
Wang [65] 2005, CnPrimary dysmenorrhea (1)Mox (Ci), 48, 1/day, 10 × 3 timesHerbn, 48(1) Cured or markedly effective rate and effective rate (2) Blood PGF2a (3) OT of serum(1) and (2) NA (3) 42/48 versus 14/48, 3.00 [1.91, 4.72]ND
Zhao [66] 2004, CnImpotence (1)Mox(Cd), 51, 1/day, 10 × 3 timesHerb, 31Vit B12(1) Cured rate (2) Total effective rate(1) NA (84% versus 71%) (2) NA (96% versus 90%)43/51 versus 22/31, 1.19 [0.92, 1.53]ND

XV-O. Pregnancy, childbirth and the puerperium

Neri [17] 2007, ItBreech presentation (2)A: Mox (S), 16(15), 2/wk B: Mox (S), 15(14), 2/wkC: Acu, 10 C: NTAcu(1) Fetal heart rate (2) Fetal movement (3) Success rate (cephalic presentation)(1, 2) NA (3) NA (80% versus 57% versus 28%)A versus C: 12/15 versus 2/10, 4.00 [1.13, 14.17] B versus C: 8/14 versus 2/10, 2.86 [0.76, 10.70]NDND
Peng [67] 2006, CnBreech presentation (1)Mox (S), 40, 2/day, 7 daysK-C position, 40Success rate (cephalic presentation)NS16/40 versus 20/40, 0.80 [0.49, 1.31]NEU
Yang [68] 2006, CnBreech presentation (2)Mox (S), 103, 2/day, 7 daysNT, 103K-C positionSuccess rate (cephalic presentation) 90/103 versus 77/103, 1.17 [1.02, 1.34]P
Cardini[16] 2005, ItBreech presentation (4)Mox (S), 65, 1-2 wkNT, 58(1) RR (cephalic presentation in the 35th wk) (2) Cephalic presentations at delivery (3) AFM count during the first week of each group (4) Compliance with treatment and adverse events(1) NS (34% versus 36%, RR 0.95, 99% CI [0.59–1.5]) (2) NA (52% versus 51%) (3) NS (254 versus 220, ) (4) NA22/65 versus 21/58, 0.93 [0.58, 1.51]NEU
Chen [69] 2004, CnBreech presentation (0)Mox (S), 73, 2/day, 3 daysNT, 69R position(1) Success rate (cephalic presentation) (2) Treatment period for co-intervention(1, 2) 67/73 versus 36/69, 1.76 [1.39, 2.23]P
Lin [70] 2002, CnBreech presentation (0)Mox (S), 63, 2/dayNT, 59K-C position(1) Success rate (cephalic presentation) (2) The mean of treatment period(1, 2) 58/63 versus 31/59, 1.75 [1.36, 2.26]P
Cardini [14] 1998, ItBreech presentation (3)Mox (S), 130, 1-2/day, 1-2 wkNT, 130(1) Cephalic presentation at 35 wk, birth and at birth (exclude subjects treated with external cephalic version, n = 129, 106, each group) (2) AFM during a 1 hr for 1 wk (3) Compliance with treatment and side effects (4) Number and causes of caesarean deliveries and use of oxytocin for vaginal deliveries (5) Apgar score <7 at 5 min(1) Each , = .020 and .004 (2) (3) NA (4) NS and (5) P =  .00698/129 versus 62/106, 1.30 [1.08, 1.57]P

ACR, American College of Rheumatology; Acu, acupuncture; AFM count, the fetal motor activity; AIDS, acquired immuno-deficiency syndrome; Auth, author; CCT, clinical controlled trial; CD4, cluster of differentiation 4; Chemo, chemo therapy; Cn, China; Co, control group; Coun, Country; CRP, C-reactive protein; C3, serum complement-3; Diet, diet therapy; Dur, Duration; EA, electroacupuncture; EGG, electrogastrography; ESR, erythrocyte sedimentation rate; ET, plasma endothelin; Ex, experiment group; FBG, fasting blood-glucose; HbA1c, hemoglobin A1c; FDI, Facial disability index; FEF25–75%, maximal midexpiratory flow rate; FEV1, forced expiratory volume in 1 second, Freq, Frequency; FVC, forced vital capacity; HAART, Highly Active Antiretroviral Therapy; HAQ, Health Assessment Questionnaire; Herb, herb medicine; HBS, House-Brackmann scale; HDL, high density lipoprotein; hr, hour (s); HRV, human rotavirus; Ig, serum immunoglobulin; IPSS, International Prostate Symptom Score; ISOA scale, index of severity of osteoarthritis; It, Italy; KDQOL-SF, Jp, Japan; KDQOL, Kidney Disease Quality of Life Short Form; K-C position, Knee-chest position; Kr, Korea; LDL, low density lipoprotein; MAS, modified Ashworth scale; Med, medication; MDA, malondialdehyde; MMS, middle molecular substance; mon, month (s); MTX, Methotrexate; NA, not available; NK cell, natural killer cell; NO, nitric oxide; NRS, numeric rating scale; NS, not significant; NSAIDs, Non-steroidal anti inflammatory drugs; NT, no additional treatment; OT, oxitocin; PPI, present pain intensity; PRI, pain rating index; QOL, quality of life; Radio, radio therapy; RF, rheumatoid factor; R position, Raising buttocks method; RR, relative risk; -SH, sulfhydryl; SOD, superoxide dismutase; TC, total cholesterol; TCD, transcranial Doppler ultrasound; TDP, Teding Diancibo Pu; TG, triglyceride; UPDRS, United Parkinson's Disease Rating Scale; VAS, visual analogue scale; vit, vitamin; Waiting, waiting list control; wk (s), week (s); WHO, Would Health Organization.
Abbreviation list of moxibustion type: Mox (Cd), moxa cone moxibustion (direct); Mox (Ci), moxa cone moxibustion (indirect); Mox (S), moxa stick moxibustion; Mox (ST), Taiyi moxa stick; Mox (S-tube), moxa stick of tube type; Mox (TF), thunder-fire wonder moxibustion; Mox (N), natural moxibustion.
Abbreviation list of control medication: a, Guben Yiliu III (GBYL), a Chinese herbal composite preparation in combination with chemotherapy; b, Mecobalamin tablets; c, Dexamethasone or Prednisone; d, Cetirizine hydrochloride; e, Smecta; f, Sulphasalazine and Metronidazole tablets; g, Motilium; h, Sulphasalazine; i, Triamcinolone and urea cream; j, Sodium Diclofenate slow-released tablet; k, Xianling Gubao capsules; l, Sulphasalazine; m, Methotrexate (MTX) and non-steroid anti-inflammatory agents (NSAIDs) n, Yueyueshu powder.
*Quality was assessed using a modified Jadad scale; **Number of high responders/number of total analyzed participants; ***P-value was calculated by χ 2 test.