Moxibustion Update

Moxibustion Update

Recently, over at Science-Based Medicine, I discussed Moxibustion. Like most pseudo-medicines it is indicated for virtually any disease, but it's main claim to fame is reversing breech presentation. Moxibusion is supposed to change the baby from feet first to head first. I was, shall we say, skeptical.

To quote me

They did a non-blinded, small, non-placebo trial in China and it appeared to be effective.

To me it would be nuts to think burning mugwort at the 5th toenail would do anything to cause a baby to shift position in the uterus and I would be inclined to think positive results would be likely to noise and not be reproducible. It wasn’t.

They repeated the study in Italy and, what a surprise, moxibustion did nothing to breech positioning.

A Cochrane Review concluded:

Moxibustion was not found to reduce the number of non-cephalic presentations at birth compared with no treatment (P = 0.45)

Now there is another negative study for moxibustion and breech presentation: Version of Breech Fetuses by Moxibustion With Acupuncture: A Randomized Controlled Trial.

As they say at the end of the discussion

Finally, treatment by moxibustion with acupuncture did not improve the version rates of fetuses in the breech position between 33 and 35 weeks of gestation. We do not think that this negative result is related to any lack of compliance by the women, any methodological defect, or a lack of statistical power.

The discussion is interesting. They go through all the pros and cons of prior studies of moxibustion and breech position. What they never discuss is the fact there is no reality-based reason that moxibustion or acupuncture would have any effect on breech position. The paper behaves as if moxibustion and acupuncture are reasonable, rational, interventions to reverse breech position.

The study was approved by their ethics and IRB committees. I always wonder what motivates IRB and ethics committees to approve of studies such as this. Sure, we need to do clinical trials, but it seems peculiar that they would approve a study where a needle is stuck in the fifth toe of pregnant women and heated until it was perceived as too hot in order to cause a baby to flip in the uterus. That is totally wackaloon from the perspective of reality. Yet they said go ahead, do the study. That alone is bizarre to me.

Money and time were spent on an intervention that, from a prior plausibility perspective, should be useless. Believers will never be convinced by negative studies; to my knowledge no pseudo-medical therapy has ever been abandoned because clinical trials prove them useless. I expect that the use of moxibustion will continue unabated despite this study.  Pseudo-medicine is reality proof.

Points of Interest 06/07/2014
Points of Interest 06/06/2014