A Systematic Review of Moxibustion for Frozen Shoulder

동결견에 대한 뜸치료 효과의 체계적 문헌고찰

Han, Si-Hoon;Lee, Gi-Eon;Byun, Da-Young;Kim, Young-Ik;Kim, Min-Kyun;Min, Boo-Ki;Lim, Han-Bit;Jeong, Yun-Jae;Oh, Min-Seok

  • Received : 2019.06.16
  • Accepted : 2019.07.08
  • Published : 2019.07.31


Objectives The purpose of this research is to evaluate the effectiveness of moxibustion theraphy for frozen shoulder through systematic review and meta-analysis. Methods The effect of moxibustion for frozen shoulder was constructed as a key question to search randomized controlled trials (RCTs) in 16 databases without type of publication restriction. Results A total of 790 studies were searched and 22 RCTs were finally selected through primary and secondary selection/exclusion process. In most of the evaluation indexes used in each study, moxibustion treatment for shoulder pain was statistically significant compared with other treatments. A meta-analysis of effective rate in 10 studies comparing moxibustion with acupuncture and acupuncture showed a statistically significant effect of moxibustion treatment. And there was a significant effect on the improvement of the shoulder mobility, but the effect size of shoulder pain was no significant effect for shoulder pain reduction. In addition in the result of meta-analysis of 4 studies' effective rate comparing moxibustion with electronic acupuncture, the effect of moxibustion was significantly higher than that of electronic acupuncture in frozen shoulder. Conclusions Moxibustion therapy was effective in symptoms in patients with frozen shoulder. However because of the high risk of bias in the quality of the included studies, the applicability of this study seems to be limited. It is thought that future randomized controlled trials will need to be designed and performed by reviewing ways to minimize bias.


Frozen shoulder;Moxibustion;Randomized controlled trial;Systematic review;Meta-analysis


  1. Han TR, Bang MS, Kang YG, Go YJ, Kim DG, Kim MJ, et al. Rehabilitation medicine. 3rd ed. Paju:Koonja Publishing. 2011:814-6.
  2. Brent BS, Robert CM. Clinical orthopaedic rehabilitation:an evidence-based approach. 3rd ed. Seoul:Hanmi. 2012:114-7.
  3. American Academy of Orthopaedic Surgeons. Essentials of musculoskeletal care. 4th ed. Seoul:Panmun Education. 2013:5-7.
  4. Clarke GR, Willis LA, Fish WW, Nichols PJR. Preliminary studies in measuring range of motion in normal and painful stiff shoulders. Rheumatology. 1975;14(1):39-46.
  5. Peggy AH, David HP. Therapeutic exercise for musculoskeletal injuries. 3rd ed. Seoul:Ymsbook. 2010:737-8.
  6. Lee YJ, Lee BL, Chea WS. Clinical study on frozen shoulder. Journal of Korean Acupuncture & Moxibustion Society. 1990;7(1):57-63.
  7. Byun JY, An SG. The clinical study on the treatment of frozen shoulder. Korean J Ori Med. 1997;3(1):279-87.
  8. Kim DH, Kim HW, Lee GH, Lee GM. Effect of scolopendrid pharmacupuncture therapy on frozen shoulder patients. Journal of Korean Acupuncture & Moxibustion Society. 2009;26(1):1-14.
  9. Hong SW. Case report combined therapy of acupuncture and fire needling is effective to treat frozen shoulder. Korean J Oriental Physiology & Pathology. 2014;28(1):122-7.
  10. Yuk DI, Song I, Ko MK, Sung IS, Kim MJ, Lee JW, Oh YS, Jo JH, Kang WC, Hong KE. Five cases of frozen shoulder patients treated by acupotomy combined with oriental medical treatments. Journal of Korean Acupuncture & Moxibustion Society. 2012;29(5):167-76.
  11. Ji CC. A survey of clinical research on moxibustion for treatment of frozen shoulder in recent ten years. Paper presented at: Proceedings of the 15th National Acupuncture Symposium of the Clinical Branch of the Chinese Acupuncture and Moxibustion Society. 2007. p. 288-90.
  12. Ryu HS, Park KS. The effects of moxibustion on chronic back pain and activities of daily living in aged. Korean J Rehabil Nurs. 2015;18(1):38-45.
  13. The Textbook Compilation Committee of The Korean Acupuncture and Moxibustion Society. The acupuncture and moxibustion, 2nd ed. Seoul:Jipmoon-Dang. 2012:327-8.
  14. National Evidence-based Healthcare Collaborating Agency. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention, Seoul:National Evidence-based Healthcare Collaborating Agency. 2011.
  15. Hwang SD. Easy to understanding meta-analysis. Seoul:Hakjisa, 2014.
  16. Zeng XL, Lei LM, Lin Z, Wang ZT. Clinical observation on acupuncture at pain point combined with moxibustion at Zusanli (ST 36) for treatment of periarthritis of shoulder. Chinese Acupuncture & Moxibustion. 2005;25(5):326-8.
  17. Han F, Zhang J. Effective observation on treating frozen shoulder by balance acupuncture on the Jiantong point and the Leihuo moxibustion. Clinical Journal of Chinese Medicine. 2017;24(9):117-8.
  18. Wang XH, Xu YZ, Hu WB, He ZG. Frozen shoulder due to cold damp treated with acupuncture and moxibustion on tender points. Chinese Acupuncture & Moxibustion. 2010;30(5):364-6.
  19. Jiang C, Liang LZ, Deng X, Ma GJ. Therapeutic effect of "Shoulder Three Points Needles (肩三針)" acupuncture combined with fire grass moxibustion on cold and wet type of frozen shoulder. Journal of Practical Traditional Chinese Medicine. 2018;34(10): 1240-1.
  20. Yan XL, Zeng GF. Clinical observation on 68 cases of periarthritis of shoulder treated by Taiyishen acupunctrue (太乙神针). Journal of Guangxi Medical University. 1999;16(5):699.
  21. Lu J, Xhang CR, Zhou X, Li J. Abdominal acupuncture combined with scarring moxibustion at Qihai (CV 6) for 15 cases of periarthritis of shoulder. World Journal of Acupuncture-Moxibustion. 2012;22(3):43-6.
  22. Wu YC, Wang CM, Zhang JF, Huang CF, Ye F. Clinical study on moxibustion-derived E-moxa for shoulder periarthritis. Shanghai Journal of Acupuncture and Moxibustion. 2012;31(10):773-5.
  23. Zhao WN. Clinical observation on treatment of periarthritis of shoulder by moxibustion shoulder point. Clinical Journal of Chinese Medicine. 2015;35(7):30-1.
  24. Li XZ. The curing effect of treatment with acupuncture near pain spot combined ginger moxibustion in 60 cases periarthritis of shoulder. Modern Hospital. 2011;11(12):46-7.
  25. Xu KS, Huang MW, Yao LY, Chen J, Su J, Zheng IQ. Clinically randomized controlled trials of moxibustion with salt in bamboo circle for treatment of periarthritis of shoulder. Chinese Acupuncture & Moxibustion. 2009;29(1):77-80.
  26. Wu B, Xu QF. Treatment of 106 cases of night pain in periarthritis of shoulder by ginger moxibustion. Zhejiang Journal of Traditional Chinese Medicine. 2013;48(2):131.
  27. Lin YX. Therapeutic effect of moxibustion combined with acupuncture exercise therapy on frozen shoulder. Nei Mongol Journal of Traditional Chinese Medicine. 2014;33(19):59-60.
  28. Xie WJ, Chang MJ. Clinical study on the treatment of periarthritis of shoulder by heat-sensitive moxibustion combined with acupuncture exercise therapy. Journal of Contemporary Medicine. 2018;25(24):125-6.
  29. Chen J. Clinical observation on 50 cases of periarthritis of shoulder treated by acupoint application of analgesia and moxibustion. Hunan Journal of Traditional Chinese Medicine. 2016;32(7):92-4.
  30. Peng CH, Liu M, Yang FY. Therapeutic effect of heat-sensitive moxibustion combined with massage on 30 cases of frozen shoulder. Jiangxi Journal of Traditional Chinese Medicine. 2018;49(5):58-9.
  31. Jin RK, Wu YC, Zheng Y, Zhuang PH, Gong XP, Yu AS. Comparative study on thermal sensitive moxibustion and needle warming moxibustion for the treatment of scapulohumeral peria. Shanghai Journal of Traditional Chinese Medicine. 2014;48(5):86-8.
  32. Ye L. Clinical efficacy observation of thermal moxibustion treatment on scapulohumeral periarthritis (cold-damp type) [dissertation]. Shandong University of Traditional Chinese Medicine; 2016.
  33. Chen S. Clinical observation on treatment of periarthritis of shoulder with acupuncture at ashi point and moxibustion zusanli. Guangming Journal of Chinese Medicine. 2011;26(11):2278-9.
  34. Wang SQ, Yang ZG, Ping WQ, Li YH, Peng H. Therapeutic effect of Chinese moxibustion acupoint application on severe periarthritis of shoulder. West China Medical Journal. 2011;26(1):87-8.
  35. Zhao JL, Chen RX, Zhang B, Fu Y, Chi ZH. Therapeutic effect of painless scar moxibustion on frozen shoulder. Journal of New Chinese Medicine. 2010;42(5):76-7.
  36. Yu DS, Yang EH. Clinical observation on acupuncture and moxibustion treatment of periarthritis of shoulder. Chinese Journal of Rehabilitation Medicine. 2004;19(2):129.
  37. Ning XJ. Effects of acupuncture plus moxibustion on frozen shoulder of Hanshi type. Clinical Journal of Chinese Medicine. 2016;17(8):34-5.
  38. Park DS, An BC, Kim JG, Kim CH. A clinical study on the effect of acupuncture treatment in pain of shoulder and arm. J Korean Med. 1981;2(2):55-61.
  39. Kim YI. Comparison study acupuncture treatment with Acupuncture & moxibustion combined treatment for forzen shoulder patients. Research Institute of Korean Medicine. 2006;15(2):1-7.
  40. Hur B, Yim YK. Study on clinical effects of indirect moxibustion at Geogol (LI16) on the shoulder pain. Research Institute of Korean Medicine. 2007;16(2):211-6.
  41. Choi YK, Kang MS. A case report of ge-yan-jiu & herbal medicine complex treatment on Jue zheng (厥證) caused by Wang yang(亡陽). J Int Korean Med. 2007;28(1):187-92.
  42. Bea GE, Lee SH, Hong JW, Lee I, Kim SY, Choi JY, Han CW, Yun YJ, Park SH, Kwon JN. Moxibustion for Benign prostatic hyperplasia: a systematic review and meta-analysis. J Int Korean Med. 2018;39(3):372-88.