SynthesisFrontiers in cellular and infection microbiology2026
Moxibustion and the gut microbiota-inflammation axis: a systematic review and meta-analysis of clinical and preclinical studies.
Synthesis in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Gut dysbiosis and aberrant inflammatory signaling are increasingly implicated in the pathogenesis of intestinal and extra-intestinal disorders. Moxibustion has been reported to modulate gut microbiota composition and inflammatory responses, but its overall effects remain incompletely characterized. Objective: To evaluate the effects of moxibustion on gut microbiota-related outcomes and inflammatory mediators in clinical and preclinical studies. Methods: PubMed, Web of Science, the Cochrane Library, CNKI, WanFang Data, and VIP were searched from database inception to December 31, 2024. Clinical and preclinical studies investigating moxibustion and reporting at least one gut microbiota-related outcome were included. Clinical and preclinical evidence was synthesized separately, with quantitative meta-analysis restricted to eligible preclinical animal outcomes. Microbiota outcomes were pooled using ratios of means (ROMs), whereas inflammatory mediators were synthesized using standardized mean differences (SMDs) under random-effects models. Metabolite- and pathway-related findings were narratively synthesized. Results: Thirty-one reports representing 30 unique studies were included, comprising 25 preclinical animal studies (26 reports) and 5 clinical studies. In animal studies, moxibustion increased Chao1 (ROM = 1.079, 95% CI [1.034-1.127]; P = 0.0005), ACE (ROM = 1.100, 95% CI [1.044-1.160]; P = 0.0004), and Shannon diversity (ROM = 1.047, 95% CI [1.015-1.080]; P = 0.0037), whereas Simpson diversity was not significantly altered. No significant pooled effects were detected for the major phyla. Conclusion: Preclinical evidence indicates that moxibustion is associated with increased microbial richness and diversity and reduced selected pro-inflammatory mediators, while taxon-specific responses are highly heterogeneous and clinical confirmation remains insufficient. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025639714.
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