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6-month symptom changes and factors associated with treatment response following combined acupuncture; moxibustion; and cupping protocol in patients with primary tinnitus: a retrospective cohort study
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DOI：10.3389/fneur.2026.1869226.png)
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Abstract
En 中文
Background: Primary tinnitus is a highly prevalent auditory disorder; affecting approximately 14.4% of adults globally. Conventional interventions yield limited efficacy. Although acupuncture-based TCM interventions is widely applied for tinnitus management; robust evidence regarding 6-month sustained symptom changes following combined TCM intervention and factors associated with treatment response remains scarce. Objective: To explore short-and long-term (6-month) symptom changes following standardized combined acupuncture; moxibustion; and cupping therapy in patients with primary tinnitus; and to analyze factors associated with treatment response Methods: We conducted a single-center retrospective cohort study at the Third Affiliated Hospital of Zhejiang Chinese Medical University; enrolling 140 patients with primary tinnitus who received standardized combined acupuncture; moxibustion; and cupping therapy between January 2024 and August 2025 and completed 6-month follow-up. The primary outcome was a ≥30% reduction in Tinnitus Handicap Inventory (THI) score from baseline; the secondary outcome was a ≥1-grade reduction in THI severity grade. Univariate screening followed by binary logistic regression was used to identify factors associated with treatment response. Results: All 140 patients completed follow-up. The primary response rate was 57.1% (80/140) at treatment completion and increased to 81.4% (114/140) at the 6-month follow-up. The secondary response rate rose from 63.6% post-treatment to 82.9% at follow-up. Multivariate regression showed that younger age (OR=0.577; P=0.028) and higher baseline THI grade (OR=1.662; P=0.008) were associated with meeting response criteria in the short term. However; neither association remained significant in sensitivity analyses excluding acute tinnitus cases (age: OR=0.683; 95% CI 0.378--1.236; P=0.208; THI grade: OR=1.486; 95% CI 0.927--2.380; P=0.100). For long-term observed THI score changes; both age (OR=0.326; P=0.003) and baseline THI grade (OR=2.699; p<0.001) were associated with meeting the primary response criterion; baseline THI grade (OR=4.455; p<0.001) and age (OR=0.266; P=0.001) predicted the secondary outcome. Gender; tinnitus laterality; disease duration; and comorbid symptoms showed no significant effects. Conclusion: Reductions in tinnitus-related handicap were observed over 6 months following combined acupuncture; moxibustion; and cupping therapy. Factors associated with treatment response varied by timepoint: for long-term changes; baseline THI severity and age were associated with greater observed score reductions; short-term associations for these factors were not robust in sensitivity analyses.
Keywords:
Acupuncture
Combined TCM intervention
Cupping
factors associated with meeting response criteria
long-term changes in THI scores
Moxibustion
Retrospective cohort study
Tinnitus
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