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Effects of moxibustion for constipation treatment: a systematic review of randomized controlled trials

DOI: 10.1186/1749-8546-5-28

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Chronic constipation is a prevalent health condition with patients typically having bowel movements twice a week or less for at least two consecutive weeks or longer. The Rome II criteria define chronic constipation on the basis of two or more of the following symptoms at least 25% of the time for at least 12 weeks in the preceding year: straining at defection, lumpy/hard stools, sensations of incomplete evacuation and three or fewer bowel movements per week [1]. Currently, there is no optimal therapeutic solution for this condition.Acupuncture and moxibustion are increasingly used for the treatment of gastrointestinal (GI) diseases [2-4]. Moxibustion is a Chinese medicine treatment whereby an acupoint is stimulated by the heat generated from burning Artemisia vulgaris [5]. Direct moxibustion is applied to the skin surface, whereas indirect moxibustion is performed with some insulating materials (e.g. ginger, salt) placed between the moxa cone and the skin [5]. The heat is then used to warm the skin at the acupoint.Chinese medicine has a unique approach to diagnosis of constipation [6]. According to Chinese medicine theory, there are four constipation patterns, namely differentiation constipation (including heat constipation), cold constipation, qi constipation and deficiency constipation. The draining method employing filiform needles is used to treat heat constipation and qi constipation [7]. In general, moxibustion is used to treat cold constipation, and deficiency constipation [8].A possible explanation is that the heat stimulates acupoints thereby increasing qi circulation and relieving qi stagnation [9], leading to increased frequency of bowel movement.Among three available systematic reviews on acupuncture for constipation [10-12], two reviews regarded constipation as part of a range of GI disorders [11,12] and included only one uncontrolled observational study. The third systematic review focused on auriculotherapy [10] and included only non-randomized clini

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