Moxibustion for treating rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials

Abstract

Introduction: Moxibustion is widely used in China and other East Asian countries to manage the symptom of rheumatoid arthritis (RA) and to lessen the adverse effects of western medicine. The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of moxibustion for treating patients with rheumatoid arthritis (RA). Methods: Seven Chinese and English databases were searched to November 2013 from their inception. Eligible RCTs were included if moxibustion was used either alone or in combination with Western medicine for treating rheumatoid arthritis. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk of bias was used to assess the methodological quality of the trials. Results: Eight RCTs met the inclusion criteria, and most were of low methodological quality. Meta-analysis showed favorable effects of moxibustion on the response rate, either alone [RR = 1.18, 95%CI (1.03, 1.35), p = 0.02; heterogeneity: Chi 2 = 1.11, p = 0.77, I 2 = 0%] or the combination with Western medicine therapy [RR = 1.28, 95%CI (1.12, 1.47), p = 0.0004; heterogeneity: Chi 2 = 1.96, p = 0.58, I 2 = 0%]. When compared with Western medicine therapy, Western medicine plus moxibustion therapy showed a favorable statistically significant effect on a reduction on American College of Rheumatology (ACR) 50 [RR = 1.57, 95%CI (1.25, 1.99), p = 0.0001; heterogeneity: Chi 2 = 2.87, p = 0.58, I 2 = 0%], whereas it failed to do so on American College of Rheumatology (ACR) 20. Additionally, when compared with western medicine therapy alone, meta-analysis of three RCTs suggested favorable but no statistically significant effects of moxibustion plus western medicine on the control of disease activities of rheumatoid arthritis.Conclusions: It is difficult to draw firm conclusions on whether moxibustion is an effective intervention for treating RA due to the small sample size of eligible RCTs and the high risk of bias among the available RCTs. Further rigorous RCTs are warranted but need to overcome methodological shortcomings of the existing evidence.

Effects of moxibustion on pain behaviors in patients with rheumatoid arthritis

“…[4,5] Previous systematic reviews of moxibustion for RA have shown that moxibustion might be beneficial to RA patients. [6,7] One [6] of these studies included 8 randomized clinical trials (RCTs) in which moxibustion was compared with drug therapy in RA patients, and suggested that moxibustion might be beneficial. The second review [7] also described some favorable effects of moxibustion in the treatment for RA.…”

Electroacupuncture plus moxibustion therapy for patients with major depressive disorder: study protocol for a randomized controlled trial

“…There have been several types of sham interventions suggested until now. It is one of the most commonly used types of sham interventions to apply acupuncture needles with a blunt edge and insulated moxibustion at nonacupoints [16–18, 31, 46–48]. No one can say for sure that it is a perfect and faultless method as a sham intervention for acupuncture and moxibustion study.…”

“…No one can say for sure that it is a perfect and faultless method as a sham intervention for acupuncture and moxibustion study. However, to date it is one of the best options that we can choose [48–50]. …”

Baguan Therapy Is an Alternative in Treating Ankylosing Spondylitis: A Systematic Review Based on Existing Randomized Controlled Trials

“…Unfortunately, due to the number of RCTs in this research, we could not set subgroup analysis to minimize heterogeneity. In a previously published article [35], in order to solve the same problem, the author, who is an expert in evidence-based complementary and alternative medicine, also used the same method that we tried. In the future we will add enough trials to set subgroup analysis to solve this problem.…”