Abstract
BACKGROUND: Moxibustion has been applied in various clinical treatments, including chemotherapy-induced leukopenia. Using a Bayesian network meta-analysis, this study assessed a wide range of published data to identify the most efficient and effective method of moxibustion therapy for treating chemotherapy-induced leukopenia. METHODS: PubMed, EMBASE, and eight other databases plus two clinical trial registration platforms were searched from their respective inception date to January 2024. All randomized controlled trials (RCTs) of moxibustion for chemotherapy-induced leukopenia were included. The primary outcome indicator was white blood cell count, and the secondary outcome was the Karnofsky performance status score. Stata (version 17.0) and the gemtc package (version 1.0-0) of R (version 4.3.1) were used to perform the network meta-analysis. RESULTS: Thirty RCTs with 2282 total patients involving 12 types of moxibustion-related therapies were identified. Results of the surface under the cumulative ranking curve revealed the following treatments as most effective for leukopenia: thunder-fire moxibustion combined with medication (95.9 %), grain-sized moxibustion combined with medication (76.2 %), and herb-separated moxibustion (76.0 %). Grain-sized moxibustion combined with medication (76.5 %) ranked first in improving Karnofsky performance status scores. CONCLUSION: Thunder-fire moxibustion combined with medication appears to be the most effective treatment for chemotherapy-induced leukopenia. PROTOCOL REGISTRATION: This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number CRD42023402588.