Direct Moxibustion to Treat Spleen Qi and Yang Deficiency Fatigue: A Pilot Study

Background Direct moxibustion (tonnetsukyu) is commonly used in Japanese Meridian Therapy (JMT) acupuncture. Limited research suggests that indirect moxibustion may be beneficial for treating fatigue, but no studies to evaluate direct moxibustion have been conducted in the United States. Objectives To assess patient safety and tolerability, explore the usefulness of four outcome measures [Flinders Fatigue Scale (FFS), SF-36, skin conductance (SC) at the Source acupoints (Yuan) and heart rate variability (HRV)] and to obtain preliminary data on the effectiveness of a specific dosing regimen of direct moxibustion for patients with spleen qi and yang deficiency fatigue (SQYDF). Design and setting: A pre- to poststudy comparison was conducted at the National College of Natural Medicine. Patients Eleven female volunteers aged 25?60 years were enrolled. Intervention Three to five rice grain to thread-sized moxa cones were burned on 11 acupuncture points, once per week for 8 weeks. Results Eight participants completed the study. The most common adverse events (AEs) were temporary worsening of fatigue (27 reports in 7 participants), lightheadedness (9 reports) and headache (7 reports). Symptomatic improvement was seen on the SF-36 Energy/Fatigue scale (p = 0.003), the SF-36 Social Function scale (p = 0.008) and the FFS (p = 0.014). SC at acupoints showed no consistent diagnostic baseline meridian patterns among participants. Usable HRV data from four participants showed an improved low frequency/high frequency (LF/HF) ratio in three of the four. Conclusions Direct moxibustion is safe and tolerable in patients with SQYDF. The FFS and SF-36 are useful outcome measures for evaluating the effects of direct moxibustion. HRV may also be a useful objective outcome measure. SC measurements did not correlate with SQYDF diagnosis or with symptomatic improvement in this small patient sample.