Modern progress of mechanism of moxibustion therapy

ZHANG Jun-feng, et al. Modern Progress of Mechanism of Moxibustion Therapy

2006 Shanghai Research Institute of Acupuncture and Meridian︱

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257

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Critical Review

Modern Progress of Mechanism of Moxibustion Therapy

ZHANG Jun-feng(张峻峰), WU Yao-chi(吴耀持)
Department of Acupuncture, Tuina and Traumatology, People's Sixth Hospital Affiliated to Shanghai Jiaotong University,
Shanghai 200233, P. R. China

提要：灸法是中医学的外治法之一，本文从灸法的灸法的药性作用和物理作用，灸法对
免疫系统、血液循环和炎症的影响，以及艾灸调节机体代谢的作用等方面进行综述。

关键词：灸法；综述文献；针灸

Summary: Moxibustion therapy is one of the external therapeutic methods. In the present
article, the pharmacological and physical actions of moxibustion therapy, and the effects of
moxibustion therapy on immune system, blood circulation, inflammation, and body metaboly
were reviewed.
Key Words: Moxibustion; Review Literature; Acupuncture-Moxibustion
CLC Number: R246.9
Document Code: A

Moxibustion therapy, one of the external

therapeutic methods, functions to disperse pathogenic
cold, warm the meridian, dredge the collateral,
promote blood circulation, remove obstruction,
restore yang, arrest proptosis, eliminate blood stasis,
resolve masses, and prevent diseases. In Yixue Rumen(
《医学入门》

), it is recorded that if some diseases

could not be dealt with medicine or acupuncture, it
should be treated with moxibustion. Traditional
Chinese medicine considers that moxa is warm and
aromatic, could dredge the twelve meridians, adjust qi
and the blood, disperse the pathogenic cold and
dampness, warm the meridian, stop pain, and prevent
miscarriage. Modern researches show that
moxibustion therapy could promote the body's
metabolism, and enhance the immune function to
prevent and treat diseases. Especially, moxibustion
therapy has good effects on various inflammation, and
inflammatory immune diseases

[1]

Pharmacological Actions of Moxibustion
Therapy

The main composition of moxa is essential oil

[2]

which functions to inhibit the bacteria growth, and
burning the moxa with different time could inhibit the
Staphylococcus aureus, beta streptococcus, Escheri-
chia coli, and Pseudomonas aeruginosa

[3,4]

. During the

moxa burning, the therapeutic effects of the

moxibustion are got through acupoints

[5]

. Modern

researches confirm some chemical substances can be
produced in the moxa burning, having therapeutic
effects, which were called burning products of the
moxa by some Japanese researchers

[6,7]

. These

substances have the effects of antioxidant and clearing
free radical and lipid peroxidation(LPO). The burning
products of the moxa could permeate the injured skin
by the moxibustion heat. The burning does not
destroy the effective composition of moxa, but
enhance its effects.

Physical Actions of Moxibustion Therapy

The heat produced in the moxa burning is a good

therapeutic factor

[5]

. The temperature at the

moxibustion skin may increase to 130℃, and inside
of the skin the temperature is around 56℃, which
indicate the moxibustion stimulation not only affects
the surface of the acupoint, but penetrates the body,
and affects the meridian qi to regulate the whole
body. Moxibustion makes the temperature of the local
skin increase, and with the temperature increase, the
pH of the extracellular fluid is also enhanced. This pH
increase only happens in the moxibustion onset, once
the moxibustion is given a long time, or repeated in a
short time, the pH is enhanced a little

[9]

. After 30 min

of moxibustion, the permeability of the local blood
vessel is the most. The heat stimulation of

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moxibustion is different from that of scald, is a kind
of physiological inflammatory response, and
functions to maintain the body balance

[10]

The burning moxa produces infrared ray with wave

length of 0.8-5.6 µm, indicating that the radiant
energy produced in the moxa burning is not only far
infrared, but near infrared, and the near infrared is the
main content

[1]

. The wave crest is around 1.5 µm, and

this kind of near infrared has short wave length, high
energy, and so it could penetrate deep tissues directly
and radiate to extensive parts through the capillary
network, therefore it could be absorbed by the body.
YANG's researches showed the infrared ray of the
moxibustion could provide cells energy for
metabolism and immune functions, and diseased cells
lack of energy activation energy.

DONG linked a thermocouple thermometer with a

computer to observe the effects of direct moxibustion,
ginger-partitioned moxibustion, suspended moxibus-
tion and neon-helium laser moxibustion on the skin
temperature of acupoints and the former four kind of
moxibustion on rabbit's skin, subcutaneous and
muscle temperature of the acupoint

[13]

. Neon-helium

laser moxibustion had little effects on acupoints
temperature, and other moxibustion changed
acupoints temperature from the skin to muscle. The
defervescence action of moxibustion is produced
through polymodal receptor related to sense of pain,
therefore, the warm effect of moxibustion is the key to
therapeutic effect

[14]

Effects of Moxibustion Therapy on Immune
System

Moxibustion could enhance the body's non-specific

immunity and specific immunity. Moxibustion streng-
thened the cytotoxicity of mice's macrophages and
natural killer cell to enhance the immunity

[15]

Meanwhile, the mitoses activity of B lymphocyte
stimulated by Staphylococcus A protein and plaque
forming were also enhanced

[16]

. After moxibustion,

activity of comple- ments(C

and C

) were also

enhanced, which confirmed moxibustion could
strengthen the body immunity

[17]

. In addition,

moxibustion at mice's Guanyuan(CV 4) and
Dazhui(GV 14) could delay thymus atrophy, and
increase the ratio of thymus and body weight

[18]

Moxibustion could enhance the activity of old

people's erythrocyte receptor(C

), help the red blood

cell clear immune complex, and antagonize serum red
cell immune adherence inhibitory factor to strengthen
the immunity of red blood cell

[19]

. Moxibustion

combining with transplantation of free skin graft
could enhance the red cell immune adherence ability,
which is low in old mice, the activity of β receptor of
red blood cell, and the contents of hypothalamus
noradrenalin. And moxibustion combining with
transplantation of free skin graft increased the
consistency of β receptor of lymphocyte indicating β
receptor may join the regulating course of
moxibustion and transplantation of free skin graft on
lymphocyte immune function

[20]

Effects of Moxibustion Therapy on Blood
Circulation

Moxibustion at Neiguan(PC 6) improved patients'

encephalic impedance showing inflow cubage rate
quickened, amplitude enhanced by 30%-50%, and
high blood pressure lowered

[21]

. Moxibustion not only

improved the cardiovascular and cerebrovascular
ability, but lowered the blood resistance and
viscosity

[22]

. Moxibustion decreased the contents of

cholesterol and triglyceride. After moxibustion,
contents of apolipoprotein A, and the ratio of
apolipoprotein A and B were increased, showing
moxibustion had marked effects on regulating
lipometabolism, slowing blood fat increase, and
preventing coronary heart disease

[23]

Moxibustion could improve blood viscosity, blood

reduced viscosity, erythrocyte sedimentation rate, K
Value of Erythrocyte Sedimentation Equation, and
Aggregation Index of RBC in old and pre-old people,
which were important in improving microcirculation,
and eliminating blood stasis

[24]

. HUANG observed

that blood viscosity, hematocrit, and penetrability of
red blood cell membrane were lower in old rats given
moxibustion than those in general old rats, and the
activity of Na

-K

-ATP enzyme of red blood cell

membrane, and metabolic ability were higher than
those of the control rats

[25]

. ZHANG considered

metabolic ability of red blood cell could reflect the
status microcirculation, and moxibustion enhanced
the metabolic ability of red blood cell to change blood
status of high consistency, viscosity, and cohesion

[26]

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Effects of Moxibustion Therapy on
Inflammation

1. Effects on inflammatory medium

In inflammation course, white blood cell,

macrophage, and blood platelet release various
inflammatory factors, leading to aggravated
inflammatory injury. Vasoactive amine-like
inflammatory agents including histamine(Hm),
serotonin(5-HT), prostaglandin(PGE2), and NO were
the major inflammatory mediums. Moxibustion
therapy lowered the serum Hm, and 5-HT of
adjuvant-induced arthritis rats, inhibited or stopped
the inflammatory responses

[27]

. Meanwhile, nora-

drenalin and dopamine in the blood inflammatory
tissues of the rats after moxibustion were more,
indicating moxibustion may activate the system of
hypothalamus, pituitary gland and adrenal cortex, and
the system of sympathetic nerve and catecholamine to
release noradrenalin and dopamine, and the blood
vessel's permeability in the inflammatory tissues were
inhibited

[27]

. HUANG's experience showed

moxibustion therapy cleared the PGE

in the local

inflammatory tissues to relieve the inflammation

[28]

NO has some physiological effects, but the excessive
NO in inflammation has similar effects of free radical
and cytotoxicity. Moxibustion at Zusanli(ST 36) and
Shenshu(BL 23) could inhibit the over production and
release of NO in inflammation

[29]

2. Effects on inflammatory factors

Cytokine induces inflammation aggravation and

development. In inflammation, contents of tumor
necrosis factor(TNF), interleukin 1β(IL-1β) are
increased, and the local and general inflammation are
aggravated. Moxibustion therapy could lower TNF
and IL-1β to a normal level, therefore, effects of
inflammatory factors are slowed or resisted

[27]

. The

content of IL-2 is enhanced after moxibustion, and the
inflammation is inhibited

[29]

. Pretreatment with

moxibustion decreased the contents of serum TNF-α,
IL-1β and IL-6, which were produced in the courses
of ischemia and reperfusion injury, and the quantity of
white blood cell. These indicated inflammatory
responses in the rats were inhibited, and the nerve
cells were protected

[30]

Nuclear factor κB (NF-κB) plays a key role in the

start of immunological response and expression of
inflammatory cytokine, and it up-regulates apoptosis

inhibitor factor and inhibits apoptosis related
molecules. Moxibustion therapy could clear NF-kB in
local tissues to inhibit the local tissues hyperplasia
and relieve the symptoms of inflammation and edema
in the local tissues

[31]

Moxibustion Therapy on the Body's
Metabolism

Activity of superoxide dismutase(SOD) and

contents of LPO reflect the balance of free radical
produced and quenched. After moxibustion the
contents of serum LPO were lowered, the activity of
SOD was enhanced, and the SOD/LPO was increased,
which indicated moxibustion therapy could improve
the disturbance of oxidation and anti-oxidation

[32]

Many biochemical changes and function regulation

induced by moxibustion, which have been reported in
recent years, are not caused by general warm
stimulation. Following the deep studies, researchers
considered the mechanism of moxibustion may be the
combing effects of warm, light radiation, and medical
effects, burning production and smell of moxa. In
summary, light and heat radiation produced by the
burning moxa could not only directly stimulate the
receptors of the local tissues to send the stimulation
signals to various nerve centers through C nerve fiber
and catecholamine nerve fiber to regulate the nerve
functions, but lead to local inflammation. And the
local blood vessel is expanded, the permeability of the
blood vessel is increased, and the local tissues are
swelled, therefore, white blood cells effuse and mast
cells lose granules to give various bioactive
substances, which enter the blood and reach all parts
of the body to induce many physiological effects. All
above-mentioned effects of moxibustion make the
body's functions changed and strengthen and the
body's ability of resisting diseases.

Concluded from present data, moxibustion therapy

may maintain patients' physiological status and
regulate immune functions through nerve and
endocrine systems. Therefore, the research of
moxibustion should focus on immune regulation, or
regulating effects on nerve, endocrine and immunity
systems to unveil the mechanism of moxibustion in
the regulating effects on the whole body. In addition,
effects of moxibustion on cells should also be paid
more attention to, such as on cell differentiation and

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apoptosis, gene expressions, and signal transportation,
which will help to deepen the researches of
moxibustion mechanism.

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Translator: SHAO Ming-hai(邵命海)

Received Date: May 20, 2006