Moxibustion therapy guided by midnight-noon ebb-flow theory on Chinese patients with ankylosing spondylitis: a quasi-experimental study

Objective: This study aimed to evaluate the effectiveness of midnight-noon ebb-flow (MNEF) theory guided moxibustion therapy for ankylosing spondylitis (AS) in terms of physical function, disease activity, health-related quality of life, inflammatory cytokines, and immune function biomarkers. Methods: 135 AS patients in Changzhou No. 2 hospital affiliated to Nanjing Medical University were randomly allocated to the control group, Moxibustion I group or the Moxibustion II group. AS patients in the control group received conventional intervention alone, while AS patients in the Moxibustion I group and Moxibustion II group received 4-week conventional moxibustion and MNEF theory-guided moxibustion therapy, respectively. Physical function, disease activity, health-related quality of life, inflammatory cytokines, and immune function biomarkers were assessed at baseline and at the endpoint week. Results: After moxibustion intervention, only performance of physical function measured by Bath Ankylosing Spondylitis Functional Index (BASFI) (F = 17.1, P < 0.01), and disease activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (F = 17, P < 0.01) were statistically significant differences between the three groups, and the Bath Ankylosing Spondylitis Metrology Index (BASMI) score were no group differences (F = 3.15, P = 0.07). The effect of MNEF-theory based moxibustion was shown to be better than conventional moxibustion therapy in the level of erythrocyte sedimentation rate (ESR) (2.67, 95% CI, 0.15 to 5.18; P = 0.04) and the radio of CD4 + CD25 + CD127 low (-2.83, 95% CI, -4.68 to -0.98; P < 0.01). However, with the use of the Tukey multiple comparisons test, compared with the conventional moxibustion therapy alone, MNEF-theory based moxibustion therapy had no statistically significant improvement in the serum levels of interleukin-6 (IL-6), interleukin-17 (IL-17), tumor necrosis factor α (TNF-α) ( P > 0.05). Conclusion: Overall, MNEF-theory guided moxibustion therapy significantly improved physical activity and health-related quality of life, reduced disease activity, and decreased systemic inflammation for AS patients.