Adverse events of moxibustion: A systematic review
Introduction
Moxibustion is an East Asian therapeutic method that uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture points.1 Direct moxibustion is applied directly to the skin's surface at an area around an acupuncture point, whereas indirect moxibustion is performed with some insulating materials (e.g., ginger and salts) placed between the moxa cone and the skin.1 The heat is then used to warm the skin at the acupuncture point.
The effectiveness of moxibustion has been tested under a wide range of conditions, from musculoskeletal disorders to gynaecological conditions.2 There are several systematic reviews on this therapeutic method that have shown a favourable effect of moxibustion for breech presentation3, 4, 5, 6 as well as limited evidence for stroke rehabilitation7 and cancer care.8 However, these studies have not provided sufficient evidence for treatment of hypertension9 or ulcerative colitis.10
The use of moxibustion may become more widespread. Currently, 67% of Korean Oriental medical doctors have used moxibustion,11 and 40% of health care in China is based on traditional Chinese medicinal approaches that include moxibustion.12 Over 15,000 general practitioners in the UK may use moxibustion on a regular basis.13 As the usage of moxibustion increases, the question of its risks become more relevant because heating of the skin during moxibustion increases the risk of adverse events such as burning, coughing and allergies due to the ingredients included in moxa pillar.
To date, no systematic review has assessed the adverse effects of moxibustion. The aim of this review was to summarise the published evidence regarding the adverse events associated with this medicinal approach.
Section snippets
Data sources
Systematic literature searches were conducted in the following electronic databases (DBs), all from their respective inceptions through July 2009 (without any language restrictions): Medline, AMED, EMBASE, CINAHL, PsycInfo, Web of Science, Cochrane Central Register of Controlled Trials, five Korean DBs (Korean Studies Information, DBPIA, Korea Institute of Science and Technology Information, KoreaMed, and Research Information Service System), a Chinese DB (CNKI) and a Japanese DB (Journal
Results
The search identified 1342 potentially relevant articles. Of these articles, 1321 studies were excluded for reasons outlined in Fig. 1. Key data from the selected articles are summarised in Table 1, Table 2.16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 The articles included 13 case reports,16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 7 clinical trials [4 randomised clinical trials (RCTs),29, 30, 31, 32 1 controlled clinical trial (CCT),33 and 2
Discussion
Adverse events related to moxibustion treatment were reported in 4 RCTs, 1 CCT, 2 UOSs, 13 case reports, and 1 prospective study. Moxibustion was used to treat several conditions. In the majority of these cases, causality was convincingly established through the sequence and/or nature of events, and some of the adverse events were related to serious complications.
Moxibustion treatment can be performed directly or indirectly. Direct moxibustion is classified into scarring and non-scarring
Author contributions
JEP and MSL designed the review, performed searches, appraised and selected trials, extracted data, contacted authors for additional data, carried out analyses and interpretations of the data, and drafted this report. SSL performed searches the Chinese databases, and selected trials, extracted data, contacted authors for additional data. EE reviewed and critiqued the review protocol and this report and assisted in designing the review.
Conflicts of interest
None of the authors have a conflict of interest.
Acknowledgments
JEP, SSL and SMC were funded by KIOM (K09050). MSL was funded by KIOM (K09050 and K10251).
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2022, European Journal of Integrative MedicineA breathable PTFE membrane for enhanced moxibustion process and occupational health protection
2022, Journal of Membrane ScienceCitation Excerpt :It mainly uses wormwood or medicine to be placed on the acupuncture points of human body to achieve healing effects by warming the meridians and stimulating the acupoints [1], and has been well applied on cardiovascular diseases, gastrointestinal diseases, rheumatism, etc. [2–5]. Smoke generated in moxibustion process by moxa sticks contains solid particles [6], organic volatile gases [7], tar [8], etc., which may cause indoor air pollution and respiratory injury, kidney diseases, and nerve injury for medical staff and patients [9–12]. Currently, smoke evacuators or air purifiers are mainly adopted in moxibustion centers to reduce the negative effect of smoke, while tars sucked in the pipeline or attached in filters may propose a fouling problem that needs to be re-treated.
Ultrasonic device developed for non-invasive moxibustion therapy
2021, Integrative Medicine ResearchCitation Excerpt :Because of the heat and burning materials, the burning moxa can cause serious pain and burns, as well as leave scars.19 In addition, unpleasant odors of the burning moxa can occur dizziness, nausea, and throat problems.20 The critical impact on the ultrasonic moxibustion therapy is to overcome these negative effects as well as provide detailed information about the design parameters, fabrication process, and its specification of the UMD.