Abstract
Poststroke depression (PSD) is a frequent neuropsychiatric complication that adversely affects recovery and quality of life in stroke survivors. Moxibustion, a traditional Chinese therapy, has been increasingly explored as an adjunctive treatment for PSD, but its clinical efficacy remains uncertain. This meta-analysis aimed to evaluate the impact of moxibustion on depressive symptoms and clinical outcomes in patients with PSD. A comprehensive search of 7 electronic databases, including PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and SinoMed, was performed from inception to July 25, 2025, without language restrictions. Twelve randomized controlled trials (RCTs) comprising 819 participants met the inclusion criteria. Pooled analysis showed that moxibustion significantly reduced Hamilton Depression Rating Scale (HAMD) scores compared with control interventions (standardized mean difference = -1.20; 95% confidence interval [CI]: -1.65 to -0.76), indicating a clinically meaningful improvement in depressive symptoms. Eight RCTs reported clinical effective rates, and the combined results demonstrated a significant advantage for moxibustion (risk ratio = 1.15; 95% CI: 1.07-1.24). Sensitivity analysis confirmed the robustness of the findings, and no significant publication bias was detected. These results suggest that moxibustion is an effective and well-tolerated complementary therapy for PSD, potentially enhancing the outcomes of conventional treatment. Further large, high-quality multicenter trials are needed to validate these findings and establish standardized treatment protocols.