Chen Guancheng, Song Wenxin, Wu Weiwei, Li Xuan, Chen Jinyan, Yang Qiao, Liao Huili
The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Department of Geriatrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Front Cardiovasc Med. 2025 Jul 15;12:1552091. doi: 10.3389/fcvm.2025.1552091. eCollection 2025.
Moxibustion has been utilized in China for 2,000 years as a safe and straightforward intervention for chronic heart failure (CHF). Numerous articles indicate that moxibustion enhances quality of life and certain heart failure indicators in CHF patients; however, there is a deficiency of high-quality, evidence-based studies with large sample sizes. Our objective was to systematically summarize and assess the clinical efficacy of moxibustion as an adjunctive treatment for CHF.
A thorough search was performed across the PubMed, Cochrane Library, Embase, Web of Science, China Knowledge Network Database, Vipers Database, Wanfang, and China Biomedical Literature Database from their inception until 1 August 2024. A meta-analysis of randomized controlled trials was utilized to aggregate the pooled metrics in patients with chronic heart failure (CHF) and to compare the clinical efficacy rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), 6 min walk test (6MWT), and cardiac output (CO) variations between standard CHF treatment and standard treatment combined with moxibustion for CHF.
The study encompassed 22 randomized controlled trials (RCTs) involving 2,039 participants, with 1,021 in the experimental group and 1,018 in the control group. The experimental group exhibited a superior clinical efficacy rate compared with the control group (RR = 1.230, 95% CI: 1.173-1.289, < 0.05), reduced NT-proBNP levels [standardized mean difference (SMD) = -1.035, 95% CI: -1.730 to -0.340, < 0.05], enhanced LVEF (SMD = 0.909, 95% CI: 0.704-1.114, < 0.001), improved 6MWT (SMD = 0.909, 95% CI: 0.704-1.114, < 0.001), and increased CO (SMD = 1.0873, 95% CI: 0.882-1.293, < 0.001). Following the application of funnel plots and the trim-and-fill method, the findings regarding clinical efficacy rate, LVEF, 6MWT, and CO were deemed reliable, whereas the results for NT-proBNP were found to be unstable. Subgroup analysis revealed that the number of moxibustion points contributed to heterogeneity in LVEF, 6MWT, and CO, while treatment duration accounted for heterogeneity in 6MWT.
The study demonstrates that, in comparison with standard treatment, the integration of moxibustion for CHF patients markedly enhanced the efficacy rate, LVEF, CO, and 6MWT and may reduce NT-proBNP levels, but this result requires further validation with larger sample sizes and standardized testing methods.
https://www.crd.york.ac.uk/PROSPERO/, PROSPERO (CRD42022372386).
艾灸在中国已被应用2000年，作为慢性心力衰竭（CHF）的一种安全且简便的干预措施。众多文章表明，艾灸可提高CHF患者的生活质量及某些心力衰竭指标；然而，缺乏高质量、大样本的循证医学研究。我们的目的是系统总结和评估艾灸作为CHF辅助治疗的临床疗效。
全面检索了PubMed、Cochrane图书馆、Embase、Web of Science、中国知网数据库、维普数据库、万方和中国生物医学文献数据库，检索时间从建库至2024年8月1日。采用随机对照试验的荟萃分析来汇总慢性心力衰竭（CHF）患者的合并指标，并比较标准CHF治疗与标准治疗联合艾灸治疗CHF的临床有效率、N末端B型利钠肽原（NT-proBNP）、左心室射血分数（LVEF）、6分钟步行试验（6MWT）和心输出量（CO）的变化。
该研究纳入了22项随机对照试验（RCT），涉及2039名参与者，其中实验组1021名，对照组1018名。与对照组相比（RR = 1.230，95%CI：1.173 - 1.289，P < 0.05），实验组临床有效率更高，NT-proBNP水平降低[标准化均数差（SMD）= -1.035，95%CI：-1.730至-0.340，P < 0.05]，LVEF升高（SMD = 0.909，95%CI：0.704 - 1.114，P < 0.001），6MWT改善（SMD = 0.909，95%CI：0.704 - 1.114，P < 0.001），CO增加（SMD = 1.0873，95%CI：0.882 - 1.293，P < 0.001）。应用漏斗图和剪补法后，临床有效率、LVEF、6MWT和CO的结果被认为可靠，而NT-proBNP的结果不稳定。亚组分析显示，艾灸穴位数量导致LVEF、6MWT和CO的异质性，而治疗持续时间导致6MWT的异质性。
该研究表明，与标准治疗相比，对CHF患者联合应用艾灸显著提高了有效率、LVEF、CO和6MWT，可能降低NT-proBNP水平，但这一结果需要更大样本量和标准化检测方法的进一步验证。
https://www.crd.york.ac.uk/PROSPERO/，PROSPERO（CRD42022372386）
