We appreciate the financial support from the Science and Technology Development Fund Project of Hospital of Chengdu University of Traditional Chinese Medicine (No. 20ZL10). The authors would like to thank Mr. Yang Yang for participating in our study as a model.

The clinical trial has been approved by the Approval Committee of the Respiratory Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (No. KY2022022). In this study, the diagnostic criteria of bronchial asthma refer to the Guidelines for Bronchial Asthma Prevent and Management (2020 edition)8 and TCM operations refer to the Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine15. The typical case was a diagnosed bronchial asthma patient admitted to the Respiratory Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. The patient&#39;s informed consent was obtained. All material sources used in the protocol can be obtained (see Table of Materials).
1. Material preparation
<ol>
	<li>Moxa Stick: Please ensure that the items listed below are available: 
	-Moxa sticks (made of moxa; their specifications are as follows: 200 mm in length and 18 mm in diameter [Table of Materials]). 
	-Ignition device (lighter [Table of Materials]) 
	-Surgical curved plate (200 mm in length and 125 mm in width [Table of Materials]) with water 
	-Gauze (minimum specification: 80 mm x 80 mm-8P [Table of Materials]) 
	-Forceps (all sterile medical forcipes are acceptable and nonessential. No special requirements [Table of Materials]) 
	NOTE: The ignition devices include matches, alcohol lamps, and lighters, according to the medical production standards, and any of them can be selected during operation. The ignition devices will extinguish the flame in time according to its manual after use. The surgical curved plate with water is to extinguish the moxa stick fire and clean the ashes after burning.</li>
	<li>Gather all the materials mentioned in steps 1.1 and put them in a medical cart for use in the procedure room (Figure 1).</li>
</ol>
2. Patient assessment
<ol>
	<li>Inclusion criteria
	<ol>
		<li>Include patients diagnosed with bronchial asthma according to diagnostic criteria8. 
		NOTE: Fully communicate with the patient and inform them of the risks brought by the operation. Have the patient sign the informed consent form. Moxibustion should be applied cautiously to those who are afraid of moxibustion. The skin area to be operated on should be complete.</li>
	</ol>
	</li>
	<li>Exclusion criteria
	<ol>
		<li>Exclude pregnant women, children, and other special groups who should not be operated on.</li>
		<li>Exclude people allergic to argyi, alcohol, and other materials. 
		&#8203;NOTE: The purpose of patient assessment is to judge whether the patient is in the appropriate condition for a moxibustion operation.</li>
	</ol>
	</li>
</ol>
3. Preoperative preparation
<ol>
	<li>Cleaning the skin area
	<ol>
		<li>The day before the operation, clean the skin area where the operation site is located two or three times with clean water to ensure that surface contaminants are removed. The radius of the cleaning range should be greater than 10 cm. Keep the skin dry after cleaning.</li>
		<li>If conditions permit, bathe and clean the skin. Ensure the water temperature is comfortable for the patient.</li>
	</ol>
	</li>
	<li>After selecting the point, use an iodophor cotton swab to disinfect the skin from inside to outside two or three times, with the acupoint as the center. The area of the sterilized skin should not be less than 5 cm x 5 cm.</li>
	<li>Before the operation, the operator must clean their hands with soapy water, according to the specification of hand hygiene for healthcare workers16.</li>
</ol>
4. Operation procedure
<ol>
	<li>Body position selection: Select the supine position or prone position for this procedure. 
	NOTE: The body position should be correctly selected according to the position of the acupoints to expose the acupoints fully.</li>
	<li>Acupoint selection
	<ol>
		<li>Locate the following acupoints according to Meridians and Acupoints17 (version 2016, published by China Traditional Chinese Medicine Publishing House): Dingchuan (EX-B1), Feishu (BL13), and Zhongfu (LU1).</li>
		<li>Locate EX-B1 at the nape back, on both sides of the midpoint of the lower edge of the spinous process of the seventh cervical vertebra 0.5 F-cun18 (Figure 2).</li>
		<li>Locate BL13 on the back side, on both sides of the midpoint of the lower edge of the spinous process of the third thoracic vertebra 1.5 F-cun (Figure 3).</li>
		<li>Locate LU1 on the chest, parallel to the first rib gap, on both sides of the anterior median line 6 F-cun (Figure 4). 
		NOTE: Take the width of the interphalangeal joint of the patient&#39;s thumb as 1 F-cun (Figure 5).</li>
	</ol>
	</li>
	<li>Light the moxa stick
	<ol>
		<li>Hold the middle and upper 1/3 of the moxa stick and light with the lighter. 
		NOTE: No other inflammable is allowed in the surrounding environment.</li>
	</ol>
	</li>
	<li>Selection of moxibustion methods
	<ol>
		<li>Mild moxibustion
		<ol>
			<li>Hold the middle and upper 1/3 of the moxa stick, aim the lighted end above the acupoint 2-3 cm away from the skin, and keep the distance constant during the operation (Figure 6).</li>
			<li>Make the operation position appear warm, local skin flushed, but with no burning pain. Keep moxibustion at each acupoint for 10-15 min; the skin temperature of the acupoint is maintained at 40-45 &#176;C, measured by a portable infrared thermometer. 
			NOTE: The degree is chosen such that the patient feels warm and the skin is slightly red.</li>
		</ol>
		</li>
		<li>Sparrow-pecking moxibustion
		<ol>
			<li>Hold the middle and upper 1/3 of the moxa stick and aim the lighted end above the acupoint, 2-3 cm away from the skin.</li>
			<li>Move the burning end of the moxa stick by moving up and down, perpendicular to the skin above the acupoint (like a bird pecking), and keep the same up and down movement (Figure 7).</li>
			<li>Make the operation position appear warm, local skin flushed, but with no burning pain. Keep moxibustion at each acupoint for 10-15 min; the skin temperature of the acupoint is maintained at 40-45 &#176;C, measured by a portable infrared thermometer.</li>
		</ol>
		</li>
		<li>Convoluted moxibustion
		<ol>
			<li>Hold the middle and upper 1/3 of the moxa stick and aim the lighted end above the acupoint, 2-3 cm away from the skin.</li>
			<li>Apply moxibustion by repeatedly rotating (like drawing a circle); draw a circle with a radius of 2.5 cm centered on the acupoint (Figure 8).</li>
			<li>Make the operation position appear warm, local skin flushed, but with no burning pain. Keep moxibustion at each acupoint for 10-15 min; the skin temperature of the acupoint is maintained at 40-45 &#176;C, measured by a portable infrared thermometer.
			<ol>
				<li>Sense the temperature during the operation. If the patient feels warm and comfortable, keep the distance unchanged. If the patient has a burning sensation, increase the distance between the moxa stick and the skin.</li>
				<li>If the patient&#39;s local skin sensation is weakened, separate the index finger and middle finger and place them on both sides of the acupoint to feel the temperature, adjust the time and distance of moxibustion according to the situation, and avoid burns.</li>
			</ol>
			</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Extinguish the fire and clean the ashes.
	<ol>
		<li>After the operation, put the ignited part of the moxa stick into a curved plate filled with water to extinguish the moxa fire. Use forceps to remove the large ash, then gently wipe the residual stains with gauze. 
		NOTE: Small blisters can naturally get absorbed. If the blisters are large, they can be punctured with a syringe or a needle and then an antibiotic ointment applied.</li>
	</ol>
	</li>
	<li>Postoperative care
	<ol>
		<li>Use forceps to remove large ashes and clean the local skin area. Then, gently wipe the residual stains with gauze.</li>
		<li>Do not touch or take cold water within half an hour after the operation. Pay attention to keep the procedure area warm. Seek timely medical advice if the patient is feeling unwell.</li>
	</ol>
	</li>
</ol>
5. Statistical analysis
<ol>
	<li>Express the continuous variables as mean &#177; standard deviation (SD). Use a paired t-test to compare the differences between before and after treatment. 
	NOTE: No categorical variables were involved in this study variable. All statistical tests were two-sided, and p &#60; 0.05 was considered statistically significant. All analyses were performed using statistical software.</li>
</ol>

The authors report no conflicts of interest.

The airway inflammation caused by bronchial asthma is a cascade immune response involving various immune cells, cytokines, and inflammatory mediators19. Bronchial biopsies of asthmatic patients show the presence of eosinophils, activated mast cells, and Th2 cell-based T cell infiltration20. Pulmonary function indexes FEV1 and PEF reflect the severity of airway obstruction, and are the most commonly used indexes for objectively judging and evaluating the condition of asthma8. Western medicine treatments for bronchial asthma are glucocorticoids, &#946;2 receptor agonists, leukotriene regulators, theophylline, and anticholinergic drugs. Glucocorticoids are the most effective in controlling bronchial asthma airway inflammation21. However, their long-term use can induce fungal infections, systemic adverse reactions, such as osteoporosis, and suppression of the hypothalamic-pituitary-adrenal axis4.
Bronchial asthma belongs to the category of asthma syndrome in TCM. The pathogenesis could be classified as the interaction and block of phlegm and vital qi, which leads to failure of the lung qi in ascending and descending. The syndrome belongs to a deficiency in origin and an excess in superficiality. The representation is the wind, cold, phlegm, heat, blood stasis, and dampness, and the deficiency of the lung, spleen, and kidney are the foundations22. The methods of treating bronchial asthma in TCM can be divided into internal and external therapies. Moxibustion is a type of external therapy, with fewer side effects, a convenient operation, and definite curative effects. Previous studies have shown that the main mechanisms of moxibustion in treating bronchial asthma are reducing the infiltration of eosinophils in peripheral blood or local lung tissue, local inflammatory response, and airway hyperresponsiveness, as well as relieving bronchial spasm and regulating the body&#39;s immune response22,23,24,25,26,27.
Moxibustion is the process of burning the Chinese medica above the acupoints or diseased parts of the human body. The photothermal effect from moxa sticks during the burning process is the key to improving the body&#39;s immunity and promoting metabolism. Moxibustion is widely used to prevent and treat diseases of various systems, including the alimentary, respiratory, and cardiovascular systems. Moreover, the therapeutic effect on some diseases even exceeds the effect of acupuncture and medicine28. Currently, many animal experiments, clinical trials, and meta-analyses have verified the effect of moxibustion in treating asthma. It can not only effectively control the symptoms of bronchial asthma patients, but also improve pulmonary function29,30,31,32,33,34,35,36,37,38,39,40. In the process of moxibustion treatment, the risks include scalding, skin allergy, and dizziness. Scalding is the most common adverse reaction; therefore, according to the study, 40-45 &#176;C is recommended as the appropriate temperature range for moxibustion to exert its efficacy and is also the temperature data frequently used in moxibustion research. In this range, it can not only play the role of immune regulation and improving blood circulation, but also prevent pain and side injury41.
In the process of moxibustion treatment, moxibustion smoke has an impact on the operator, mainly manifested in respiratory symptoms and eye discomfort. Therefore, the therapy time of moxibustion and the control of concentration of moxibustion smoke become the key to avoid adverse reactions. Operators should take measures to prevent scalding and smoke in advance, and control the time of moxibustion and the concentration of moxibustion smoke to ensure the safety of the patient and the operator.
Acupoints are the reaction point of disease acting on the body and the entry point of treatment. Acupoints are closely related to the viscera through meridians, which not only reflect the physiological or pathological functions of the viscera, but also are effective stimulation points for the treatment of diseases of viscera. Asthma is often caused by lung disease, which is caused by external pathogenic factors such as stiff attack, improper diet, emotional stimulation, physical Deficiency, and fatigue. Zhang et al. analyzed the clinical acupoint selection rule of moxibustion of asthma according to the literature42. The disease location of asthma is mainly in the lung; its original meridian is the Lung Channel of Hand-Taiyin. The Feishu point is the main treatment, so it can be used for the treatment of asthma. Shu- and Mu- point association for treatment is one of the classic acupoint matching methods. The combination of Shu- And Mu- points can achieve a synergistic effect. In TCM, the disease is located in the lung. The Feishu and Zhongfu acupoints are the Shu- and Mu- points of the lung, respectively, which can regulate viscera and relieve cough and wheezing43,44,45,46. Moxibustion can significantly improve immune function, inhibit airway inflammation and reduce airway hyperresponsiveness, relieve clinical symptoms, and improve the quality of life of patients through Shu- and Mu- point association47,48,49. Moreover, the Dingchuan acupoint is also widely used clinically because of its definite curative effect on bronchial asthma. It is an extra acupoint outside the meridian and an empirical acupoint for the treatment of asthma. External treatment at the Dingchuan acupoint can effectively inhibit the infiltration of eosinophils, reduce airway inflammation and hyperresponsiveness, and finally achieve the goal of treating bronchial asthma50,51,52.
While western medicine effectively controls the onset of bronchial asthma, side effects and adverse reactions also emerge in an endless stream, and the treatments are comparatively limited21. Moxibustion, as one of the external therapies of TCM for bronchial asthma, gives full play to the characteristics and advantages of TCM, makes up for the shortcomings of internal therapies, shows great advantages, and provides more effective means for the treatment of bronchial asthma.
Our study is a single center study with a relatively small sample size, so we hope to expand the sample size in future studies to minimize bias.

The protocol presented here demonstrates the operation of moxibustion in treating bronchial asthma in terms of patient management, material preparation, acupoint selection, operation, and postoperative nursing. The purpose of this protocol is to control the symptoms of patients with bronchial asthma and improve lung function by moxibustion.
Acupuncture and moxibustion are important components of traditional Chinese medicine (TCM). Concerning bronchial asthma, acupuncture and moxibustion have accumulated extensive clinical experience in treatments, and moxibustion in particular has shown unique advantages1,2,3,4. Modern studies show that the effects of the biological mechanism of warming promotion and supplementation of moxibustion are as follows: moxibustion activates the acupoints (local starting), promotes the movement of qi and blood, regulates the neuroendocrine-immune network (regulatory pathway), and regulates the functions of the viscera (response of the effector organ)5,6,7.
Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest tightness, or cough, due to the increased airway reactivity. These symptoms often occur or worsen at night or in the morning8. Bronchial asthma is one of the most common chronic lung diseases in the world, affecting people of all ages9. In recent years, the prevalence of bronchial asthma in China has been increasing yearly. The latest epidemiological survey showed that the prevalence of asthma in adults over 20 years old is 4.2%10. The disease will lead to airway remodeling and hyperreactivity, which will seriously affect the pulmonary function of patients in the late stage. Currently, the main clinical treatments for bronchial asthma are anti-inflammatory, antispasmodic, and symptomatic treatments. Nevertheless, the high recurrence rate and intractability outline the main disadvantages, let alone the poor long-term drug efficacy and lack of an ideal therapeutic schedule. Compared with inhaled drugs alone, moxibustion could enhance humoral and cellular immunity, which have a significant immunomodulatory effect during treatment11,12,13. By burning and roasting the Chinese medica above human acupoints, moxibustion is a type of treatment that works through drugs and heat stimulation. It has effects such as dispelling cold sensations by warming the meridians, promoting qi circulation to remove the meridian obstruction, and eliminating stagnation to activate meridians. It is regarded as a TCM characteristic therapy for bronchial asthma14.

<table><tbody><tr><td>Forceps</td><td>Shandong Weigao Group MEDICAL Polymer Co., Ltd.</td><td>Shandong Medical Device Registration Certificate: No.20182640148</td><td></td></tr><tr><td>Gauze</td><td>Shandong Angyang Medical Co.,Ltd</td><td>Shandong Medical Device Registration Certificate: No.20152140569</td><td></td></tr><tr><td>Lighter</td><td>Ningbo Qiant Technology Co., Ltd</td><td>Chaofan-CF-1</td><td></td></tr><tr><td>Moxa Stick</td><td>Nanjing Tongrentang Lejialaopu Health Technology Co., Ltd</td><td>10028859806337</td><td></td></tr><tr><td>Surgical Curved Plate</td><td>Yuekang Hardware Medical Instrument Factory, Caitang Town, Chao&#039;an District, Chaozhou City</td><td>Medium Size</td><td></td></tr></tbody></table>

a traditional chinese medicine characteristic therapy for bronchial asthma: moxibustion

Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest tightness, or cough, as a result of increased airway reactivity. With high diurnal variation, these symptoms often occur or worsen at night or in the morning. By burning and roasting the Chinese medica above human acupoints, moxibustion is a type of treatment that stimulates the activity of the human meridians through drugs and heat stimulation to prevent and treat diseases. According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, acupoints are selected on the corresponding parts, which has a definite effect. It is regarded as a characteristic traditional Chinese medicine therapy for bronchial asthma. This protocol elaborates the methods and steps of patient management, material preparation, selection of acupoints, operation, and postoperative nursing to ensure safe and effective moxibustion treatment to significantly improve the clinical symptoms and quality of life of patients with bronchial asthma.

Eight patients with bronchial asthma who met the criteria were treated with moxibustion. All patients had the same diagnostic criteria for bronchial asthma, and the patients' pulmonary function FEV1 ratio, PEF ratio (actual/expected; percentage), and asthma control test (ACT) scores were measured before and after the moxibustion treatment in the same way. After one course of treatment, all patients had improved pulmonary function FEV1 ratio, PEF ratio, and ACT scores. Before treatment, the pulmonary function FEV1 ratio was 68.23% ± 4.35%, the PEF ratio was 65.91% ± 4.34%, and the ACT score was 16.13 ± 2.30 points. After treatment, the pulmonary function FEV1 ratio was 77.33% ± 5.53%, the PEF ratio was 77.69% ± 4.97%, and the ACT score was 22.38 ± 1.60 points. These differences were statistically significant (p &lt; 0.05) (Table 1).
In a typical case, a 71-year-old female came to the clinic with recurrent interglottic croup for 10+ years, and cough and tightness of breath for 1+ months, exacerbated for 2 days. The patient met the diagnostic criteria for bronchial asthma, and after excluding contraindications, the patient was informed of the moxibustion procedure and the purpose of treatment, and she voluntarily participated in this trial. The patient was conscious on admission, with cough and sputum, tightness in the chest, aggravated by activity, nocturnal seated breathing, white smooth tongue coating, and a tight pulse. According to these symptoms, the patient was identified as having cold croup in TCM. The moxibustion protocol described above was applied to the Dingchuan (EX-B1), Feishu (BL13), and Zhongfu (LU1) acupoints for 15 min each time, once a day for 7 days.
Before treatment, the patient complained of coughing with frequent tightness in the chest. The examination showed that the pulmonary function FEV1 ratio was 58.9%, PEF ratio was 56.8%, and ACT score was 13. Computer tomography (CT) of the chest showed obvious lung inflation with thickened and disturbed lung texture (Figure 9). After treatment, the patient complained of occasional cough and sputum, and the tightness of the chest improved significantly. The examination showed that the pulmonary function FEV1 ratio was 69.1%, the PEF ratio was 70.4%, and ACT score was 20. Chest CT showed an improvement in lung inflation and partial reduction in pulmonary texture disorder (Figure 9). After treatment, the patient's clinical symptoms improved significantly, the pulmonary function suggested improvement, and the ACT score increased significantly (Table 2).
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/65119/65119fig01.jpg"> 
Figure 1: Operating materials. (A) Moxa stick. (B) Lighter. (C) Surgical curved plate. (D) Gauze. (E) Forceps. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupuncture points diagram, marking Dingchuan (EX-B1) on the upper back for therapeutic reference." class="xfigimg" src="/files/ftp_upload/65119/65119fig02.jpg" data-altupdatedat="1747911167000" data-alt="Figure 2"> 
Figure 2: Dingchuan (EX-B1) acupoint position. At the nape back, on both sides of the midpoint of the lower edge of the spinous process of the seventh cervical vertebra 0.5 F-cun. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupuncture point BL13 diagram, highlighting Feishu location for therapeutic use." class="xfigimg" src="/files/ftp_upload/65119/65119fig03.jpg" data-altupdatedat="1747911167000" data-alt="Figure 3"> 
Figure 3: Feishu (BL13) acupoint position. On the back side, on both sides of the midpoint of the lower edge of the spinous process of the third thoracic vertebra 1.5 F-cun. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig03large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupuncture diagram showing Zhongfu (LU1) point on shoulder with body axis measurement scale." class="xfigimg" src="/files/ftp_upload/65119/65119fig04.jpg" data-altupdatedat="1747911167000" data-alt="Figure 4"> 
Figure 4: Zhongfu (LU1) acupoint position. On the chest, parallel to the first rib gap, on both sides of the anterior median line 6 F-cun. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig04large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Thumb with measurement line indicating 1 F-cun, anatomical diagram for acupressure or acupuncture." class="xfigimg" src="/files/ftp_upload/65119/65119fig05.jpg" data-altupdatedat="1747911167000" data-alt="Figure 5"> 
Figure 5: Measurement diagram of 1 F-cun. Take the width of the interphalangeal joint of the patient's thumb as 1 F-cun. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig05large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupressure method application, hand using tool to press acupoint on skin, therapeutic diagram." class="xfigimg" src="/files/ftp_upload/65119/65119fig06.jpg" data-altupdatedat="1747911167000" data-alt="Figure 6"> 
Figure 6: Operation diagram of mild moxibustion. Hold the middle and upper thirds of the moxa stick, aim the lighted end above the acupoint, 2-3 cm away from the skin, and keep the distance constant during the operation. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig06large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupuncture technique diagram using pressure point measurement with hand-held device." class="xfigimg" src="/files/ftp_upload/65119/65119fig07.jpg" data-altupdatedat="1747911167000" data-alt="Figure 7"> 
Figure 7: Operation diagram of sparrow-pecking moxibustion. Hold the middle and upper thirds of the moxa stick and aim the lighted end above the acupoint, 2-3 cm away from the skin. Move the burning end of the moxa stick by moving up and down perpendicular to the skin above the acupoint (like a bird pecking), and keep the same up and down movements. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig07large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Acupuncture point location process using moxibustion technique; diagram showing application method." class="xfigimg" src="/files/ftp_upload/65119/65119fig08.jpg" data-altupdatedat="1747911167000" data-alt="Figure 8"> 
Figure 8: Operation diagram of convoluted moxibustion. Hold the middle and upper thirds of the moxa stick and aim the lighted end above the acupoint, 2-3 cm away from the skin. Apply moxibustion by repeatedly rotating (like drawing a circle), with a radius of 2.5 cm centered on the acupoint. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig08large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Lung CT scans with lesions; comparison study, identifying anomalies; diagnostic image analysis." class="xfigimg" src="/files/ftp_upload/65119/65119fig09.jpg" data-altupdatedat="1747911167000" data-alt="Figure 9"> 
Figure 9: Chest CT performance before and after treatment. (A) Before treatment. (B) After treatment. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/65119/65119fig09large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Variables</td>
			<td>N</td>
			<td>Before treatment</td>
			<td> After treatment.</td>
			<td>P value</td>
		</tr>
		<tr>
			<td>FEV1(%)</td>
			<td>8</td>
			<td>68.23±4.35</td>
			<td>77.33±5.53</td>
			<td>&lt;0.05</td>
		</tr>
		<tr>
			<td>PEF(%)</td>
			<td>8</td>
			<td>65.91±4.34</td>
			<td>77.69±4.97</td>
			<td>&lt;0.05</td>
		</tr>
		<tr>
			<td>ACT(score)</td>
			<td>8</td>
			<td>16.13±2.30</td>
			<td>22.38±1.60</td>
			<td>&lt;0.05</td>
		</tr>
	</tbody>
</table>
Table 1: The effect of moxibustion on patients' pulmonary function FEV1 ratio, PEF ratio, and ACT score.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Variables</td>
			<td>Before treatment</td>
			<td> After treatment</td>
		</tr>
		<tr>
			<td>FEV1(%)</td>
			<td>58.90%</td>
			<td>69.10%</td>
		</tr>
		<tr>
			<td>PEF(%)</td>
			<td>56.80%</td>
			<td>70.40%</td>
		</tr>
		<tr>
			<td>ACT(score)</td>
			<td>13</td>
			<td>20</td>
		</tr>
	</tbody>
</table>
Table 2: Results of a typical case.

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A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion

This protocol presents a curative procedure of moxibustion in treating patients with bronchial asthma.

Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest ...

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3.2K Views.  Hospital of Chengdu University of Traditional Chinese Medicine. Moxibustie is een traditionele Chinese geneeswijze die algemeen wordt erkend als een effectieve behandeling voor bronchiale astma. Het kan zowel de humorale als de cellulaire immuniteit verbeteren en heeft een significant immunomodulatoreffect tijdens de behandeling. Moxibustie heeft effecten zoals het verdrijven van koude sensaties door de meridianen op te warmen, het bevorderen van de chi-circulatie om de meridiaanobstructie te verwijderen en het elimineren van stagnatie om de meridianen te...

Video: A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks. Bronchial thermoplasty is delivered by the Alair System and is performed in three outpatient procedure visits, each scheduled approximately three weeks apart. The first procedure treats the airways of the right lower lobe, the second treats the airways of the left lower lobe and the third and final procedure treats the airways in both upper lobes. After all three procedures are performed the bronchial thermoplasty treatment is complete.
Bronchial thermoplasty is performed during bronchoscopy with the patient under moderate sedation. All accessible airways distal to the mainstem bronchi between 3 and 10 mm in diameter, with the exception of the right middle lobe, are treated under bronchoscopic visualization. Contiguous and non-overlapping activations of the device are used, moving from distal to proximal along the length of the airway, and systematically from airway to airway as described previously. Although conceptually straightforward, the actual execution of bronchial thermoplasty is quite intricate and procedural duration for the treatment of a single lobe is often substantially longer than encountered during routine bronchoscopy. As such, bronchial thermoplasty should be considered a complex interventional bronchoscopy and is intended for the experienced bronchoscopist. Optimal patient management is critical in any such complex and longer duration bronchoscopic procedure. This article discusses the importance of careful patient selection, patient preparation, patient management, procedure duration, postoperative care and follow-up to ensure that bronchial thermoplasty is performed safely.
Bronchial thermoplasty is expected to complement asthma maintenance medications by providing long-lasting asthma control and improving asthma-related quality of life of patients with severe asthma. In addition, bronchial thermoplasty has been demonstrated to reduce severe exacerbations (asthma attacks) emergency rooms visits for respiratory symptoms, and time lost from work, school and other daily activities due to asthma.

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks.

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled ...

Moxibustion Strategies for Mice

The field of moxibustion research is expanding, with a rapid increase in publications in recent years. Moxibustion is a therapy that ignites moxa on the skin of humans, with an increase in peripheral skin temperature and localized redness. During this treatment, the recipient must remain still to prevent scalding and expose intervention sites for easy manipulation; however, maintaining a fixed posture during moxibustion is a big challenge for animals. Thus, manipulating moxibustion in small animals, such as mice, can lead to several difficulties for researchers. In addition, an uncomfortable posture for animals can lead to fear and resistance to moxibustion, increased risk of injury, diminished animal welfare, and less valid research data. An efficient, comfortable moxibustion method is needed to protect animal welfare and minimize the adverse effects on experimental results. However, moxibustion methods are highly variable and often have limited efficacy. More importantly, an uncomfortable moxibustion posture might cause a stress response, such as those observed with anxiety, fear, and anger, which could influence the research data. Therefore, strategies for animal moxibustion that inflict the least harm possible during the intervention are required. This protocol introduces a mouse tethering method for moxibustion intervention, minimizing mouse discomfort and improving study efficiency. Essential strategies for tethering mice and application of moxibustion are highlighted, and the structure of the tethering instrument is described.

The present protocol describes a moxibustion application method for mice, with the benefits of reducing mouse fearfulness, guaranteeing their welfare, and improving efficiency for researchers.

The field of moxibustion research is expanding, with a rapid increase in publications in recent years. Moxibustion is a therapy that ignites moxa on the ...

Behavior

Standardized Operation Process of Zhuang Medicine Line Moxibustion in Rats

Medicated Thread Moxibustion Therapy of Zhuang Medicine and its Application in a Rat Model of Cold-Congealing Syndrome of Primary Dysmenorrhea

Zhuang medicine thread moxibustion therapy is one of the national intangible cultural heritages. It is a Zhuang medicine characteristic therapy that involves igniting ramie thread soaked in Zhuang medicine preparation solution and directly moxibustion on a certain acupoint or part of the body surface. This treatment method is characterized by combining drug, acupoints, and moxibustion, stimulating the skin's receptors at the acupoints through the warmth of moxibustion, affecting the biochemical metabolism of histiocyte and the function of the nervous system so that the drug ingredients can be absorbed through the skin. However, the therapeutic effect of Zhuang medicine line moxibustion is influenced by factors such as moxibustion intensity, heat intensity, and moxibustion frequency. Manual operation cannot precisely control each influencing factor. Here, we design a Zhuang medicine line moxibustion simulation instrument to maintain a constant force, heat, and frequency. The frequency and heat can be adjusted according to experimental needs, and it can be applied to the study of analgesic experiments to observe the analgesic effect of Zhuang medicine line moxibustion on pain animal models to solve the standardization problem of Zhuang medicine line moxibustion in the operation process of experimental animals.This study establishes a model of primary dysmenorrhea in rats with cold coagulation syndrome and provides a detailed introduction to the preparation, process, and precautions of Zhuang medicine thread moxibustion on the model of primary dysmenorrhea in rats with cold coagulation syndrome. The intervention of Zhuang medicine thread moxibustion on primary dysmenorrhea in rats with cold coagulation syndrome is evaluated by twisting score and infrared thermal imaging body surface temperature detection, intuitively demonstrating the therapeutic effect of Zhuang medicine thread moxibustion, and a preliminary analysis of its mechanism of action is conducted.

Author Spotlight: Demonstrating Therapeutic Effect of Automated Zhuang Medicine Line Moxibustion Simulator

This article demonstrates the standardized operation process of Zhuang medicine line moxibustion in experimental animals. To achieve repeatability and accuracy of Zhuang medicine line moxibustion, we developed a simulator to maintain strength, heat, and frequency. We constructed a dysmenorrhea model for experimental verification in rats with cold coagulation syndrome.

Zhuang medicine thread moxibustion therapy is one of the national intangible cultural heritages. It is a Zhuang medicine characteristic therapy that ...

Exploring the Therapeutic Potential of Du-Moxibustion in Ankylosing Spondylitis

Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a progressively worsening and disabling form of arthritis that primarily affects the axial skeleton. This disease mainly involves the spine and the sacroiliac joint. Fusion of the spine and the sacroiliac joint may occur in the later stage of the disease, resulting in spinal stiffness and kyphosis, as well as difficulty in walking, which seriously affects the quality of work and daily living activities and imposes a heavy burden on the patient, the family, and society. Increasing attention has been paid to non-pharmacotherapy as an alternative therapy for AS. Moxibustion is an ancient therapeutic technique used in Traditional Chinese Medicine (TCM). Du-moxibustion therapy, a unique and innovative external treatment developed on the basis of ordinary moxibustion, has a definite therapeutic effect on AS. Du-moxibustion skillfully combines the compatible techniques of TCM to integrate meridians, acupoints, Chinese herbal medicine, and moxibustion. This paper describes the operation procedures and precautions to be taken during Du-moxibustion in experimental mice in detail to provide an experimental basis for the study of the mechanism of Du-moxibustion in the treatment of AS.

Author Spotlight: Evaluating Traditional Chinese Therapy for Ankylosing Spondylitis in Mice 

This paper describes in detail the operation procedures and precautions to be taken during Du-moxibustion in the treatment of ankylosing spondylitis in experimental mice.

Ankylosing spondylitis (AS) is a progressively worsening and disabling form of arthritis that primarily affects the axial skeleton. This disease mainly ...

Immunology and Infection

Acupuncture in a Rat Model of Asthma

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes methods for the fabrication of the high platform, establishes a rat model of asthma and measures changes in respiratory function using a noninvasive and real-time whole-body plethysmography (WBP) system.

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes ...

Three-Dimensional Finger Motion Tracking during Needling: A Solution for the Kinematic Analysis of Acupuncture Manipulation

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D motion tracking technology to measure the kinematic parameters of the joints of fingers during acupuncture manipulation (AM) and establish three technical indicators "amplitude, velocity and time". This method can reflect the operation characteristics of AM and provide quantitative parameters along three axes of multiple finger joints. The current evidence shows that the method has great potential for future applications such as the study of the dose-effect relationship of acupuncture, teaching, and learning of AM, and the measurement and preservation of famous acupuncturists' AM.

This experimental method describes a solution for the kinematic analysis of acupuncture manipulation with three-dimensional finger motion tracking technology.

Three-dimensional (3D) motion tracking has been used in many fields, such as the researches of sport and medical skills. This experiment aimed to use 3D ...

Warm Acupuncture and Moxibustion to Relieve COPD with Abdominal Distension

A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Author Spotlight: An Effective Traditional Chinese Medicinal Treatment for Chronic Obstructive Pulmonary Disease with Abdominal Distension 

Here, we present a protocol to properly manipulate warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease (COPD) with abdominal distension.

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute ...

A Moxibustion Platform for Herbal Cake-Based Treatment of Rats with Renal Failure

Using Herbal-Cake-Separated Moxibustion for the Treatment of Rats with Chronic Renal Failure

In the process of moxibustion in clinical practice, subjects need to be in a stable mood and comfortable posture to avoid problems such as moxa ash falling, scalding skin, and poor curative effect. Such problems also exist in the rat moxibustion experiment. To simulate clinical practice, it is necessary to introduce an experimental instrument in animal experiments, that is, a moxibustion device with fixed rats and moxibustion treatment synchronization, which can make experimental rats receive moxibustion treatment quietly and comfortably under non-anesthesia.
Our research group designed a rat moxibustion experimental platform. The device was framed by a wooden board with a supporting base plate, multiple fixed components, and partitioned components. The device can achieve the operation mode of moxibustion in rats without binding, avoiding anesthesia and scalding and simultaneously exposing multiple acupoints on the back. This operation can avoid physical and mental injury to rats and operators, which improves the research efficiency and further promotes the development and research of moxibustion animal experiments.
The device has a simple structure, is easy to operate and popularize, is comprehensively and innovatively designed, reusable, and is suitable for rat experiments mainly based on moxibustion. This article mainly introduces the structure of the experimental platform device for rat moxibustion, the basic procedure of herbal-cake-separated-moxibustion in experimental rats using the device and describes the establishment of a rat model of chronic renal failure (CRF) and representative experimental results.

Author Spotlight: Understanding the Effect of Herbal-Cake-Separated Moxibustion in Rats with Renal Faliure

The moxibustion experimental platform can fix the rats without restriction, and the rats can undergo multi-acupoint moxibustion in the awake state, ensuring the welfare of the rats, protecting the safety of the operators, ensuring therapeutic efficacy, and improving the efficiency of the experiment.

In the process of moxibustion in clinical practice, subjects need to be in a stable mood and comfortable posture to avoid problems such as moxa ash ...

Herbal Moxibustion on Shenque Acupoint for Alleviating Primary Dysmenorrhea

Herbs-Partitioned Moxibustion on the Navel in a Rat Model of Primary Dysmenorrhea with Cold Coagulation and Blood Stasis

Primary dysmenorrhea (PDM) refers to the occurrence of spasmodic colicky pain in the lower abdomen without any obvious pelvic pathology, often accompanied by other systemic symptoms, which significantly reduces the quality of life of women with PDM, 45%-95% of menstrual women are affected by it. Despite the high incidence of PDM, it is often not well treated and is ignored by relevant researchers and women themselves. Herbs-partitioned moxibustion (HPM) is a characteristic external therapy in traditional Chinese medicine (TCM), which is widely used to treat diseases in China; it treats diseases by applying a Chinese herbal formula on the patient's acupoints and then igniting moxa sticks on the herbal formula for moxibustion therapy. The primary effectiveness of the herbs utilized in this study is meridian activation and warmth, which encourages qi circulation to relieve pain. Moxibustion's heat stimulation could hasten the infusion of the herbs into the human body. Consequently, HPM, which combines acupoint, herbal, and heat stimulations, is appropriate for treating gynecological disorders, particularly functional diseases such as PDM. This paper provides a detailed description of the procedures and precautions for HPM at the Shenque (CV8) acupoint in female experimental rats, which 0provides an experimental basis for better promoting the application and development of HPM on the navel in PDM.

Here, we describe in detail the operation procedures and precautions to be taken during herbs-partitioned moxibustion on the navel in the treatment of primary dysmenorrhea in rats with cold coagulation and blood stasis, which can significantly improve the writhing reaction of dysmenorrhea rats and alleviate pain.

Primary dysmenorrhea (PDM) refers to the occurrence of spasmodic colicky pain in the lower abdomen without any obvious pelvic pathology, often accompanied ...

Assessing the Efficacy of Ginger Moxibustion in Diarrhea Management in COPD

Ginger Moxibustion, A Non-pharmacological Treatment, for Diarrhea in Patients with Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a common and frequently occurring disease in the elderly population, and it tends to progressively worsen. Diarrhea is a common extrapulmonary complication in patients with COPD. Diarrhea can cause dehydration, electrolyte imbalances, weakness, and a loss of appetite, among other adverse consequences, which seriously affect the quality of life and nutritional status of patients. These consequences are not conducive to improving airway obstruction in COPD patients. At present, modern medicine has poor curative effects, fails to control symptoms fully, causes a relapse after drug withdrawal, has side effects, and increases the medication burden of patients. Ginger moxibustion is a unique non-pharmacological therapy of traditional Chinese medicine, which is safe and effective in controlling diarrhea, has few side effects, and is easy to accept. It is, therefore, an ideal alternative therapy. This article aims to introduce the protocol of ginger moxibustion for treating diarrhea in COPD patients.

Author Spotlight: Exploring Non-Pharmacological Therapies for Chronic Respiratory Diseases &#8212; Linking Intestinal Microbiome Insights to COPD Treatment

Here, we present the method of using ginger moxibustion to treat diarrhea in patients with chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD) is a common and frequently occurring disease in the elderly population, and it tends to progressively worsen. ...

A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion

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