A phase 1/2 pilot study of acupuncture and moxibustion at Zusanli (ST36) as a prophylactic treatment in middle-aged and elderly individuals

Zusanli (ST36), one of the most essential acupoints in clinical acupuncture practice, is considered as an intervention strategy for disease prevention and longevity promotion in traditional Chinese medicine (TCM). However, the prophylactic effects of ST36 have yet to be investigated in clinical studies. In the present study, we conducted a single-arm, open-label, pilot clinical trial to evaluate the prophylactic effects of stimulating the ST36 acupoint through acupuncture and moxibustion in middle-aged and elderly participants. Of the 85 participants who completed the first 2 months of acupuncture and moxibustion, 48 continued through the remaining 4 months to complete the full 6-month intervention. For 6 months acupuncture and moxibustion at ST36 significantly reduced levels of low-density lipoprotein (LDL) and uric acid (UA) in individuals with initially abnormal LDL and UA values. The median LDL levels decreased from 4.46 mmol/L (IQR 4.32-4.71) to 3.97 mmol/L (IQR 3.32-4.47) (P = 0.004) and the median UA levels decreased from 399.00 µmol/L (IQR 356.00-483.00) to 361.00 µmol/L (IQR 323.00-421.00) (P = 0.003). Additionally, ST36 intervention led to marked reductions in the levels of lactic dehydrogenase (LDH) (266.50 U/L (IQR 257.50-282.25) to 235.50 U/L (IQR 215.50-244.75), P < 0.001) at 6 months, and α-hydroxybutyrate dehydrogenase (α-HBDH) (195.50 U/L (IQR 190.25-212.00) to 181.00 U/L (IQR 165.75-187.25), P = 0.017) at 2 months. Notably, ST36 acupuncture and moxibustion also showed positive effects on sleep quality, knee joint function, and bowel movement patterns, and there were no syncope, severe pain or other adverse reactions. These findings provide clinical evidence that ST36 acupoint stimulation confers holistic health benefits for middle-aged and elderly populations, while maintaining an excellent safety profile.