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The Effect of Moxibustion Treatment for Cardiac Arrhythmia : A Systematic Review

Article information

J Korean Med. 2019;40(3):99-111
Publication date (electronic) : 2019 September 30
doi : https://doi.org/10.13048/jkm.19030
Lee Bora1orcid_icon, Hwang Juyeong1orcid_icon, Kwon Jungnam1,2,orcid_icon
1Dept. of Korean Medicine, School of Korean Medicine, Pusan National University
2Dept. of Internal Medicine, Korean Medicine Hospital of Pusan National University
Correspondence to: Kwon Jungnam School of Korean medicine, Pusan National University 49, Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea. Tel: +82-55-360-5659, Fax: +82-55-360-5559, E-mail: jnkwon@pusan.ac.kr
Received 2019 April 13; Revised 2019 June 16; Accepted 2019 July 10.

Abstract

Objectives

The purpose of this study was to assess the effects of moxibustion treatment for Cardiac arrhythmia through a systematic review.

Methods

Electronic database including Cochrane library, Pubmed, China National Knowledge Infrastructure, Embase, DBpia, and Korean studies Information Service System were searched by combining the keywords such as “arrhythmias”, “cardiac arrhythmias”, “心律失常”, “moxibustion” and “艾灸”. Through the searching, 5 randomized controlled trials(RCTs) were included except animal testing and cellular experiment etc. The quality of each RCTs was assessed using the Cochrane risk of bias tool.

Results

We included 5RCTs involving 468 participants. Two RCTs compared moxibustion versus conventional treatment, another RCT compared moxibustion plus acupuncture versus conventional treatment, another RCT compared moxibustion plus herbal medicine verus conventional treatment, the other RCT compared moxibustion plus herbal medicine and ointment versus conventional treatment. These studies were evaluated by the efficacy rate of treatments. Studies measured outcomes in efficacy, heart rate, electrocardiogram and symptoms. Each of 5 trials statistically showed a significant differences in efficacy rate. One study reported about side effects and another study reported about complications. The overall risk of bias was unclear in 5 studies.

Conclusions

The evidence suggests that moxibustion treatment may help to reduce cardiac arrhythmia, however, it is limited, low-certainty and we cannot rule out benefits or risks with this treatment. High-quality studies that report adverse effects are needed.

Keywords: Moxibustion; Cardiac arrhythmia; acupuncture point
Fig. 1

Flow chart of the trial selection process.

Fig. 3

Risk of bias summary.

Fig. 2

Risk of bias for included studies.

Number of studies searched for Arrhythmia and Moxibustion.

Characteristics of Randomized Controlled Trials Included in the Systematic Review.

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Article information Continued

Copyright © 2019 The Society of Korean Medicine all rights reserved

Fig. 1

Fig. 1

Flow chart of the trial selection process.

Fig. 3

Fig. 3

Risk of bias summary.

Fig. 2

Fig. 2

Risk of bias for included studies.

Table 1

Number of studies searched for Arrhythmia and Moxibustion.

Database No. of studies
Cochrane 16
PubMed 23
Embase 4
CNKI 32
DBpia 0
KISS 0

Table 2

Characteristics of Randomized Controlled Trials Included in the Systematic Review.

Study Paricipants Sample size (range of age) Experimental group Control group Outcome measurements Results
Intervention Duration/Dates of session/ No. of session Acupoint
Liu10 (2010) CA A: 32/32
B :32/32 (16≤age≤75)		 MOXA Moxa : 1 session : 30min/day(10days)+5days rest
total : 2~4 session		 BL14, BL15, BL16, BL17 (Bilateral) Amiodarone, Metoprolol aspirin Digoxin

  1. Heart rate

  2. ECG

 A:93.7%(30/32)
B:78.1%(25/32)
A>B**
Yu11 (2013) CBA A: 30/30
B: 30/30 (54≤age≤75)		 MOXA Bamboo salt moxa: 50min/1day
total : 10 days		 BL15 , CV14 xinbao-wan

  1. Heart rate

  2. ECG

  3. ST-T changes

  4. tongue and pulse condition

 A:83.3%(25/30)
B:60.0%(18/30)
A>B*
Zou12 (2009) CA A: 38/38
B: 37/37 (16≤age≤69)		 MOXA+ACU Ginger moxa: 1 session : 1time/day+5days rest/ 1 set : 10 session
total : 2~4 set

  • Moxa: PC6, SP4, HT7, PC5, HT5, BL15, BL20, BL14, BL17, ST36

  • Acu: PC6

 Amiodarone, Metoprolol, aspirin, Digoxin

  1. Heart rate

  2. ECG

  3. atrial fibrillation

 A: 97.4% (35/38)
B: 81.1% (30/37)
A>B*
Qu13 (2018) CBA A: 49/49
B: 49/49 (20≤age≤85)		 MOXA+ Herbal Medicine Salt moxa: 1 seesion : 1time/day+ 1day rest (3Zhuang/1time)/ 3 session
Drug: You gui-wan 1session : 3time/1day (4 weeks)
total : 3 session		 CV17, CV8, CV4 Atropine sulfate tablets

  1. subjective symptoms (heart palpitation, chest tightness, weakness, dizziness, Reduced memory)

  2. Heart rate

  3. ECG

 A : 89.8% (44/49)
B : 81.6% (40/49)
A>B
Feng14 (2013) CA A: 86/86
B: 85/85 (65≤age≤90)		 MOXA+ Herbal Medicine+ Ointment Moxa: 40min/1day
Zhi gancao-tang
Zhi gancao-tang
Ointment: 6H/1day / total : 1month

  • Moxa: CV8, CV12, CV6, CV4

  • Ointment: CV8, CV12, CV6, CV4

 xinbao-wan

  1. Heart rate

  2. ECG

 A : 93.02% (80/86)
B : 69.41% (59/85)
A>B*
*

CA : Cardiac Arrhythmia;

†

CBA : Cardiac Bradycardia Arrhythmia;

‡

MOXA : Moxibustion ;

§

ACU : Acupuncture;

||

A: Experimental group; B: Control group.

ECG : electrocardiogram, A>B* : P value < 0.05, A>B** : P value < 0.001