PM10 mass concentration and oxidative capacity of moxa smoke

Efficacy and safety of moxibustion as a complementary and alternative therapy for asthma: A systematic review and meta-analysis

OBJECTIVE

This systematic review of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of moxibustion as a complementary or alternative treatment for asthma.

METHODS

Seven databases were searched up to June 23, 2024, to identify RCTs assessing moxibustion for bronchial asthma. The outcomes of interest included response to treatment, asthma control, quality of life, lung function, immunological indicators, and incidence of adverse events (AEs). The treatment effects were measured by proportional odds ratios or mean differences with 95% confidence intervals.

RESULTS

Thirty-seven RCTs (n = 2,879) were included. Moderate- to very low-quality evidence showed that compared with anti-asthmatic drugs alone, moxibustion plus anti-asthmatic drugs led to a significantly better response and greater increases in lung function, asthma control, and IgE levels. However, the combination therapy had no effect on children's quality of life. In the active comparisons, moxibustion resulted in a superior response to treatment and a greater improvement in asthma control and had comparable effects on lung function, quality of life, and IgE levels compared with anti-asthmatic drugs. The effects of moxibustion on the proportions of CD4 + and CD8 + T cells and the eosinophil count were inconsistent between the add-on and active comparisons. All reported AEs related to moxibustion were mild.

CONCLUSIONS

Moxibustion, as an adjunctive treatment or used alone, may improve the response to treatment, lung function, asthma control, and IgE levels in patients with asthma with good safety. Its effects on children's quality of life and immune cell levels remain uncertain.

The Mechanism Study of Moxa Combustion Products on Regulating Vascular Endothelial Function in Atherosclerotic Mice

Objective

To evaluate the anti-atherogenic effect of moxa combustion products (MCPs) and whether it is mediated through improving the vascular endothelial function in ApoE^−/− mice.

Methods

A total of 60 male ApoE^−/− mice were randomly divided into the moxa smoke (MS) group, filtered moxa smoke (FMS) group, moxa floss volatile (MFV) group, essential oil of Artemisia argyi (EOAA) group, and model group (n = 12/group), while 12 male C57BL/6 mice were used as the control group. The six groups were intervened for 20 min/day, 6 days/week. After 14 weeks of intervention, the mice were euthanized and their blood lipids were measured. The aortic roots and thoracic aortas were collected for haematoxylin and eosin (HE) or Oil Red O staining, respectively. The contents of AMPK, PI3K, Akt, and eNOS mRNA in the thoracic aortas were examined by RT-qPCR.

Results

The MS group and FMS group showed significantly lower plaque area percentage in the aortic roots and thoracic aortas and higher contents of AMPK-mRNA and eNOS-mRNA in the thoracic aortas compared with the model group.

Conclusion

MS and FMS equally suppressed the progression of atherosclerotic lesions in ApoE^−/− mice. It was suggested that the particulate matter in MS may not be the key components of moxibustion.

Distribution, sources, risks, and vitro DNA oxidative damage of PM2.5-bound atmospheric polycyclic aromatic hydrocarbons in Urumqi, NW China

Research has focused on the impacts of polycyclic aromatic hydrocarbons (PAHs) in the atmosphere due to their potential carcinogenicity. In this study, we investigated the seasonal variation, sources, incremental lifetime cancer risks (ILCR_S), and vitro DNA oxidative damage of PAHs in Urumqi in NW China. A total of 72 atmospheric samples from Urumqi were collected over a year (September 2017-September 2018) and were analyzed for 16 PAHs that are specifically prioritized by the U.S Environmental Protection Agency (U·S EPA). The highest PAHs concentrations were in winter (1032.66 ng m^-3) and lowest in spring (146.00 ng m^-3). Middle molecular weight PAHs with four rings were the most abundant species (45.28-61.19% of the total). The results of the diagnostic ratio and positive matrix factorization inferred that the major sources of atmospheric PAHs in Urumqi were biomass burning, coking, and petrogenic sources (52.9%), traffic (30.1%), coal combustion (8.9%), and the plastics recycling industry (8.1%). ILCR_S assessment and Monte Carlo simulations suggested that for all age groups PAHs cancer risks were mainly associated with ingestion and dermal contact and inhalation was negligible. The plasmid scission assay results showed a positive dose-response relationship between PAHs concentrations and DNA damage rates, demonstrating that toxic PAHs was the primary cause for PM_2.5-induced DNA damage in the air of Urumqi.

Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients.

Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326.

Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15–0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19–0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28–1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08–0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43–2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20–0.68, p = 0.0004), and anxiety (MD = −4.90, 95% CI −7.83 to −1.98, p = 0.001) in breast cancer patients compared with the control group.

Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.

Efficacy and safety of electric heating moxibustion for perennial allergic rhinitis: protocol for a randomized controlled trial

BACKGROUND

Allergic rhinitis (AR) is an IgE-mediated disease that adversely affects quality of life. Many studies report that moxibustion is an effective treatment for perennial allergic rhinitis (PAR). However, it is difficult to perform moxibustion on the face because of possible burning of the skin and the noxious effects of smoke. Electric heating moxibustion does not have these limitations. The purpose of this clinical trial is to assess the possibility of treating PAR with electric heating moxibustion and to assess the feasibility of conducting a clinical test on a larger scale.

METHODS

This is a randomized, open-label, assessor-blind, parallel-design pilot clinical study. We will recruit 40 eligible participants and randomly allocate them into an electric heating moxibustion group or an acupuncture group at a 1:1 ratio. Patients in both groups will receive eight treatments over 4 weeks, and the final follow-up will be 4 weeks after the last treatment. Eleven acupuncture points will be used for patients in both groups (EX-HN3 and bilateral EX-HN-8, LI20, LI4, GB20, and ST36). The primary outcome measure is change in the Total Nasal Symptom Score, and the secondary outcome measures are changes in the Rhinoconjunctivitis Quality of Life Questionnaire, nasal endoscopy index for pattern identification, pattern identification questionnaire for AR, total IgE, eosinophil count, and adverse effects.

DISCUSSION

This clinical trial will examine the effect of electric heating moxibustion on PAR.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03342105 . Registered on 14 November 2017.

Lung Function Decline after 24 Weeks of Moxa Smoke Exposure in Rats

OBJECTIVE

Moxibustion is a complementary therapy that has been used for thousands of years. Burning moxa produces smoke and inhalable particulates. Recent research has indicated that smoke inhalation is associated with negative lung effects. This study aimed to evaluate the lung function of rats after moxa smoke exposure at different concentrations.

METHODS

Using a randomised block experiment design, 28 male Wistar rats were randomly divided into three moxa smoke groups (opacity) (n=7): low concentration (27.45 mg/m3), medium concentration (168.76 mg/m3), and high concentration (384.67 mg/m3) with a control group. Rats in the moxa smoke groups were exposed in an automatic dynamic exposure device separately with different concentrations for 20 min/d, 6d/week, for 24 weeks. Rats in the control group were exposed in the same space without moxa smoke. Lung function was evaluated by the AniRes 2005 animal pulmonary function analysing system. Statistical Product and Service Solutions 18.0 software was used for data analysis.

RESULTS

In the study, no deaths were found in any group. There was no difference of forced expiratory volume in one second/forced vital capacity percentage (FEV1/FVC%), inspiratory resistance (Ri), and expiratory resistance (Re) among each group after 24 weeks of moxa smoke exposure (P>0.05). Compared with the control group (0.33 ml/cmH20), dynamic compliance (Cdyn) was reduced in the medium (0.29 ml/cmH20) and high (0.25 ml/cmH20) concentration groups (P<0.05); however, Cdyn in the low concentration group (0.29 ml/cmH20) was not significantly affected.

CONCLUSION

Moxa smoke exposure at low concentrations did not affect the rat's lung function. Moxa smoke of medium and high concentrations destroyed the lung function represented by decreased Cdyn. However, moxa smoke of low concentrations (27.45 mg/m3) is much higher than the concentration in a regular moxibustion clinic (3.54 mg/m3). Moxa smoke at higher concentrations might destroy the lung function. The safety evaluation of moxa smoke requires further research.

Heteroatom-doped porous carbons derived from moxa floss of different storage years for supercapacitors

Two novel carbons (MCs) derived from moxa floss of different storage years have been prepared by two low-cost and facile approaches, which are hydrothermal carbonization at a low temperature (200 °C) and direct pyrolysis at a moderate temperature (500 °C) followed by potassium hydroxide (KOH) activation strategy at a high temperature (800 °C), respectively. The physicochemical properties of MCs are investigated by Raman spectra, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), field-emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), and nitrogen adsorption-desorption isotherms. Results show that MCs derived from moxa floss of different storage years by two facile approaches possess different morphologies: MCs by hydrothermal carbonization (denoted as MC-1, MC-2 and MC-3) exhibit porous nanosheet structures, the highest specific surface area is about 1788.6 m2 g-1, and the largest total pore volumes is around 0.8170 cm3 g-1, while MCs by direct pyrolysis (denoted as MC-4, MC-5 and MC-6) have basically blocky and rod-like morphologies, the highest specific surface area is about 1628.0 m2 g-1, and the largest total pore volume is around 0.7058 cm3 g-1. However, despite the different morphologies, all MCs possess a similar hierarchical porous structure, numerous heteroatom groups and good electrical conductivity. Therefore, these low-cost, biomass-derived porous carbons with promising capacitive performance are used for supercapacitors application with high performance, for example, the as-assembled supercapacitor based on MC-5 exhibits a high specific capacitance of 288.3 F g-1 at 0.25 A g-1, an excellent rate performance of 243.5 F g-1 even at 30 A g-1 with 84.5% capacitance retention of its initial specific capacitance, and an outstanding long-term cycling stability with 98.7% capacitance retention after 10 000 cycles at 5 A g-1. Furthermore, the maximum energy density for these supercapacitors with an aqueous electrolyte in a two-electrode system is about 10.0 W h kg-1 at a power density of 70.3 W kg-1. Therefore, this work opens up a whole new field for the applications of moxa floss and this novel concept of moxa floss use is an extremely promising strategy for developing high-performance carbons with porous structures and heteroatom-doping from renewable sources.

PM2.5 and ash residue from combustion of moxa floss

BACKGROUND

Moxibustion, a Traditional Chinese Medicine technique, involves burning moxa floss to apply heat to certain points or areas of the body surface to treat disease. Moxibustion releases a considerable amount of smoke into the environment. There remains controversy over the safety of moxa smoke and its potential effects on human health.

METHODS

We measured the PM2.5 (particulate matter with aerodynamic diameter <2.5 μm) mass concentration in moxa smoke and the oxidative capacity of PM2.5 and moxa ash (using a plasmid scission assay in whole and water-soluble fractions) in the by-products of moxibustion produced from burning moxa floss of different ratios (3:1 or 15:1) and duration of storage (3 or 10 years) in three simulated moxibustion clinics.

RESULTS

PM2.5 mass concentration was 224.28, 226.39  and 210.56 μg/m(3) for samples A (3 years and 3:1 ratio), B (3 years and 15:1 ratio), and C (10 years and 3:1 ratio), respectively. Average D500 oxidative damage of PM2.5 was 29.42%, 29.16% and 27.01% and that of moxa ash was 22.78%, 20.60% and 21.42% for samples A, B and C, respectively. PM2.5 demonstrated a significantly greater oxidative capacity than moxa ash (p<0.05).

CONCLUSIONS

The oxidative DNA damage induced by individual PM2.5 following moxibustion was lower than that reported in other environments. However, PM2.5 mass concentration after moxibustion is still relatively high. We would recommend ensuring adequate ventilation during moxibustion to reduce any possible risks. Further studies are needed to better define the potential impact of particles in moxibustion by-products on human health.

Contrasts in spatial and temporal variability of oxidative capacity and elemental composition in moxibustion, indoor and outdoor environments in Beijing

Moxibustion is a traditional Chinese medicine therapy that burns moxa floss which produces a substantial amount of PM10 into the environment, thus spawning safety concerns about health impacts of the smoke. We compared the oxidative capacity and elemental composition of moxibustion-derived and ambient PM10 in summer and winter to provide a source-, spatial- and temporal-comparison of PM10 biological responses. The PM10 oxidative capacity was 2.04 and 1.45 fold lower, and dose-dependent slope gradient was 2.36 and 1.76 fold lower in moxibustion environment than indoor or outdoor. Oxidative damage was highly correlated with iron, cesium, aluminum and cobalt in indoor, but moxibustion environment displayed low associations. The total elemental concentration was also lower in moxibustion environment than indoor (2.28 fold) or outdoor (2.79 fold). The source-to-dose modeling and slope gradient analysis in this study can be used as a model for future source-, spatial- and temporal-related moxibustion safety evaluation studies.