Historical and contemporary applications of moxibustion at Gaohuang (BL 43). / 膏肓灸古今应用探析.

The relevant passages on moxibustion at Gaohuang (BL 43) in the Chinese Medical Code (fifth edition), and relevant literature on moxibustion at Gaohuang (BL 43) published up to January 17th, 2023 in the CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase and Scopus were searched. The localization and selection methods of Gaohuang (BL 43), types of moxibustion at Gaohuang (BL 43), moxibustion quantity, and the main clinical indications were analyzed. As a result, a total of 227 ancient passages were included, with 51 related to moxibustion quantity and 171 related to clinical indications, encompassing 33 different diseases. A total of 50 modern articles were reviewed, covering 26 different diseases. The key of selection methods of Gaohuang (BL 43) is exploring sensitivity around the scapula, with direct moxibustion as a preferred technique; the optimal moxibustion dose is detenuined by arrival and withdrawal of deqi, and primary indications were related to syndrome of heart and lung deficiencies.

Experimental observation of effects of acupoints, cone numbers and durations of moxibustion with different moxibustion methods on skin surface and inside temperature / 针灸推拿医学（英文版）

Objective: To observe the effects of acupoints, cone numbers and durations of moxibustion with different moxibustion methods on skin surface and inside temperature, and to provide references for the clinical standardization of moxibustion amount. Methods: The 42 big-ear white rabbits were divided into 6 groups according to the random number table method, a 1-cone direct moxibustion group, a 2-cone direct moxibustion group, a 3-cone direct moxibustion group, a 1-cone herbal cake-partitioned moxibustion group, a 2-cone herbal cake-partitioned moxibustion group, and a 3-cone herbal cake-partitioned moxibustion group, with 7 rabbits in each group. Shenque (CV 8), Shenshu (BL 23) and Zusanli (ST 36) were used in each group, but the moxibustion methods, cone numbers and durations of moxibustion were different. Rabbits in each group received moxibustion once every other day for 5 times in total. During the intervention, a thermoelectricity coupled probe and a temperature recorder were used to record the real-time acupoint skin temperature and the temperature at different time points, so as to observe, analyze and process the real-time changes in the temperature difference between the surface and inside of acupoint skin. Results: For herbal cake-partitioned moxibustion, the best temperature for cone changing was (46.38±0.51) ℃ when the highest surface temperature was (49.20±0.52) ℃; the multi-factor comparison of acupoint × cone number × time and acupoint × moxibustion method × time showed that time × acupoint, time × moxibustion method and cone number × acupoint had interactive effects (all P<0.05). Comparing skin temperature differences between different cone numbers at the same acupoint, Shenque (CV 8) on the 1st and the 5th days, Shenshu (BL 23) on the 3rd and the 7th days, Zusanli (ST 36) on the 1st and the 9th days of experiment showed statistically significant differences (all P<0.05). The skin temperature comparison of different moxibustion methods at the same acupoint all had statistical differences (all P<0.05), except for Shenque (CV 8) before moxibustion, Shenshu (BL 23) before moxibustion and on the 5th day; Zusanli (ST 36) only showed statistical differences on the 5th and 7th days (both P<0.05). The skin temperature differences of different acupoints after moxibustion in the 1-cone, 2-cone and 3-cone groups were statistically different (all P<0.05); direct moxibustion and herbal cake-partitioned moxibustion at different acupoints were all statistically different (all P<0.05). Conclusion: Cone changing temperature under the same specifications of herbal cake-partitioned moxibustion was confirmed. Temperature difference between surface and inside of different acupoint skin at the same maximum temperature was significantly different due to the cone numbers and moxibustion methods, which showed the highest at Shenshu (BL 23), the second at Shenque (CV 8), and the lowest at Zusanli (ST 36). The influence of acupoint factor should be considered to determine the quantitative indicators of moxibustion.

Clinical efficacy comparison of moxibustion with different doses for knee osteoarthritis / 针灸推拿医学（英文版）

Objective: To compare the efficacy of moxibustion with different doses for knee osteoarthritis (KOA), and explore the correlation between moxibustion dose and clinical efficacy. Methods: Sixty-eight patients with KOA who met the inclusion criteria were randomly divided into a 20-minute moxibustion group and a 40-minute moxibustion group by the random number table method, with 34 cases in each group. Dubi (ST 35), Neixiyan (EX-LE 4) and Heding (EX-LE 2) were used for moxibustion in the two groups. Each treatment lasted 20 min or 40 min for each point in the 20-minute moxibustion group and 40-minute moxibustion group, separately; the treatment was given 3 times a week and lasted for 4 weeks. The visual analog scale (VAS), Western Ontario and McMaster University osteoarthritis index (WOMAC) and traditional Chinese medicine (TCM) symptom scores were evaluated before and after treatment to compare the efficacy between different moxibustion doses for KOA. Results: After treatment, the total effective rate was 87.5％ in the 40-minute moxibustion group, versus 70.0％ in the 20-minute moxibustion group, and the difference in the total effective rate between the two groups was statistically significant (P<0.05). After treatment, the VAS scores, the total WOMAC scores and the component scores of pain, stiffness and dysfunction, and the TCM symptom scores in both groups all changed significantly when compared with those before treatment (all P<0.05). After treatment, the between-group differences in the VAS score, the total WOMAC score and the component scores of pain and dysfunction, and the TCM symptom score were statistically significant (all P<0.05), while the difference in the stiffness score in WOMAC showed no statistical significance (P>0.05). Conclusion: Either 20-minute moxibustion or 40-minute moxibustion can relieve pain, improve stiffness, dysfunction, and TCM symptoms for KOA; and 40-minute moxibustion is better in relieving pain, improving dysfunction and TCM symptoms.

Research progress on factors influencing therapeutic efficacy of moxibustion / 针灸推拿医学（英文版）

As a crucial component of acupuncture-moxibustion therapy, moxibustion has been extensively propagated and used with its significant efficacy, simple operation, inconspicuous adverse effects and less sufferings. There are a variety of factors that influence the therapeutic efficacy of moxibustion. The influencing factors, including moxibustion dose (moxibustion duration, distance between moxa and skin, size and number of moxa cone), selection of points, moxibustion sensations, and the type of moxibustion were analyzed and summarized, to provide references for approaching the maximum efficacy of moxibustion in clinic.

Research progress on factors influencing therapeutic efficacy of moxibustion / 针灸推拿医学（英文版）

As a crucial component of acupuncture-moxibustion therapy, moxibustion has been extensively propagated and used with its significant efficacy, simple operation, inconspicuous adverse effects and less sufferings. There are a variety of factors that influence the therapeutic efficacy of moxibustion. The influencing factors, including moxibustion dose (moxibustion duration, distance between moxa and skin, size and number of moxa cone), selection of points, moxibustion sensations, and the type of moxibustion were analyzed and summarized, to provide references for approaching the maximum efficacy of moxibustion in clinic.

Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome.

AIM: To identify an appropriate therapeutic regimen for using aconite cake-separated moxibustion to treat diarrhea-predominant irritable bowel syndrome (D-IBS). METHODS: A factorial design was employed to examine the two factors of moxibustion frequency and number of cones. The two tested frequencies were three or six moxibustion sessions per week, and the two tested doses were one or two cones per treatment. A total of 166 D-IBS patients were randomly divided into four treatment groups, which included each combination of the examined frequencies and doses. The bilateral Tianshu acupoints (ST25) and the Qihai acupoint (RN6) were selected for aconite cake-separated moxibustion. Each patient received two courses of treatment, and each course had a duration of 2 wk. For each group, the scores on the Birmingham irritable bowel syndrome (IBS) symptom questionnaire, the IBS Quality of Life scale, the Self-Rating Depression Scale (SDS), the Self-Rating Anxiety Scale (SAS), the Hamilton Depression (HAMD) scale, and the Hamilton Anxiety (HAMA) scale were determined before treatment, after the first course of treatment, and after the second course of treatment. RESULTS: The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all 4 aconite cake-separated moxibustion groups were significantly lower after the first and second courses of treatment than before treatment (P < 0.001 for all). The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all four aconite cake-separated moxibustion groups were significantly lower after the second course of treatment than after the first course of treatment (P < 0.001 for all). Between-group comparisons after the second course of treatment revealed that the symptom scores for group 1 (1 cone, 3 treatments/wk) and group 3 (2 cones, 3 treatments/wk) were significantly lower than that for group 2 (1 cone, 6 treatments/wk) (5.55 ± 5.05 vs 10.45 ± 6.61, P < 0.001; 5.65 ± 4.00 vs 10.45 ± 6.61, P < 0.001). Regarding the two levels of the two examined factors for aconite cake-separated moxibustion, after the first course of treatment, the changes in HAMA scores were significantly different for the two tested moxibustion frequencies (P = 0.011), with greater changes for the "6 treatments/wk" groups than for the "3 treatments/wk" groups; in addition, there were interaction effects between the number of cones and moxibustion frequency (P = 0.028). After the second course of treatment, changes in symptom scores for the 2 tested moxibustion frequencies were significantly different (P = 0.002), with greater changes for the "3 treatments/wk" groups than for the "6 treatments/wk" groups. CONCLUSION: An aconite cake-separated moxibustion treatment regimen of 3 treatments/wk and 1 cone/treatment appears to produce better therapeutic effects for D-IBS compared with the other tested regimens.

Key Points and Solutions to Enhance the Curative Effects of Moxibustion Therapy / 针灸推拿医学（英文版）

Objective: To elucidate the key effects of moxibustion points and quantity of moxibustion used in order to enhance the curative effect of moxibustion therapy. Methods: It analyzed the occurrence rules of acupoint heat-sensitization and its relationship to the moxibustion location and dose, in view of the original definition of acupoints in Nei Jing (Internal Canon) and the acupoint heat-sensitization in clinical practice. Results: (1) The original definition of acupoint is the reflecting area of a disease on surface of the body, which is individualized, motive and sensitive; (2)The location in which heat-sensitization is generated relating to a heat-sensitive acupoint, which therefore depicts the best choice for point selection and also the most accurate area to give moxibustion; (3) The heat-sensitization time can be taken as a clinical index to quantify the moxibustion dose, in order to apply sufficient moxibustion for each individual. Conclusion: The key points for enhancing the curative effect of moxibustion therapy are to identify heat-sensitive points and a scientific moxibustion dose.