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This network meta-analysis pooled data from forty randomised controlled trials involving 3,718 participants to compare different moxibustion-containing treatment combinations for diabetic peripheral neuropathy, a common and debilitating complication of diabetes that damages peripheral nerves. The combinations examined included moxibustion alone or paired with acupuncture, massage therapy, internal herbal medicine, external herbal medicine, or conventional treatment.
The most consistent findings emerged for moxibustion combined with external herbal medicine. Compared with conventional treatment, this combination improved nerve conduction velocity in both motor and sensory nerves across the common peroneal and median nerve pathways. It also reduced scores on the Toronto Clinical Scoring System, a validated measure of neuropathy severity, and nearly doubled the likelihood of a markedly effective clinical response. These results were supported by moderate-certainty evidence, lending them reasonable credibility. Moxibustion combined with acupuncture also outperformed conventional treatment for median sensory nerve conduction velocity and the markedly effective rate, though certainty for some of these outcomes was lower.
The authors acknowledge that the underlying trials varied in quality and that further rigorous research is needed to confirm these findings before strong clinical recommendations can be made.
Conclusion: Moderate-certainty evidence from this network meta-analysis suggests that moxibustion combined with external herbal medicine may meaningfully improve nerve conduction, symptom severity, and overall treatment response in people with diabetic peripheral neuropathy, supporting its potential role as a useful adjunct to conventional care.
Source: Du D, Wang S, Chen X and colleagues. Frontiers in endocrinology (2026). View on PubMed (PMID 42755773) · doi:10.3389/fendo.2026.1941999