Acupuncture Protocol for Tinnitus Treatment Response

A standardized combination of acupuncture, moxibustion, and cupping therapy was associated with substantial reductions in tinnitus-related distress, with benefits increasing over six months. According to a new retrospective study, 57.1% of patients met the primary response threshold at treatment completion, a figure that rose to 81.4% at the six-month follow-up.

Study Design: A Six-Month Follow-Up of Combined TCM Therapy

Conventional interventions for primary tinnitus, a condition affecting roughly 14.4% of adults globally, often provide limited relief. While acupuncture-based TCM therapies are commonly used, high-quality evidence on their long-term effects is scarce. To address this, researchers Yi Zhu, Ke Fang, and Lianqiang Fang conducted a single-center retrospective cohort study at the Third Affiliated Hospital of Zhejiang Chinese Medical University.

The study enrolled 140 patients with primary tinnitus who received a standardized protocol combining acupuncture, moxibustion, and cupping therapy between January 2024 and August 2025. All participants completed a six-month follow-up. The researchers used the Tinnitus Handicap Inventory (THI), a validated questionnaire, to measure outcomes. They defined a primary response as a ≥30% reduction in THI score from baseline and a secondary response as a ≥1-grade reduction in THI severity grade (e.g., from moderate to mild).

Findings: Response Rates Increased Over Six Months

The results showed a clear pattern of sustained improvement. Immediately after treatment, 57.1% (80 out of 140) of patients met the primary response criterion. At the six-month follow-up, this response rate had increased to 81.4% (114 patients). Similarly, the secondary response rate rose from 63.6% post-treatment to 82.9% at follow-up.

This increase suggests the therapeutic effects of the combined TCM intervention may not only persist but continue to develop after the treatment course ends. The pattern aligns with a concept seen in other neuromodulatory approaches, where neural changes initiated during treatment consolidate over time. This mirrors findings in other fields, such as cognitive behavioral therapy for insomnia, where baseline characteristics can predict long-term outcomes.

Who Responds Best? Age and Baseline Severity Matter

The researchers used statistical modeling to identify which patient factors were associated with a positive treatment response. Their analysis revealed that the significant factors depended on whether they assessed short-term or long-term outcomes.

For the long-term, six-month results, two factors stood out. Younger age was associated with a greater likelihood of achieving a response. Patients with a higher baseline THI grade—meaning more severe initial tinnitus handicap—were also more likely to experience a significant reduction in their score. This could indicate that those with greater room for improvement show more measurable change.

In the short-term analysis immediately post-treatment, age and baseline THI also appeared significant. However, in a sensitivity analysis that excluded patients with acute tinnitus, these associations were no longer statistically robust. Factors such as gender, whether tinnitus was in one or both ears, how long the patient had tinnitus, and comorbid symptoms did not significantly affect outcomes in either analysis.

This focus on predictive factors connects to a broader research goal in hearing disorders: identifying which patients are most likely to benefit from a specific intervention. Similar work is being done with brain imaging to predict tinnitus treatment success.

Practical Implications and Future Research

This study provides preliminary evidence that a combined TCM protocol may offer a sustained benefit for many patients with primary tinnitus, with effects potentially growing for months after treatment. The finding that younger patients and those with higher initial distress may respond better can help guide clinical discussions and patient expectations.

It is important to note the study’s limitations. As a retrospective, single-center study without a control group, the results indicate an association but cannot prove the therapy caused the improvements. The observed benefits could be influenced by the natural course of tinnitus or placebo effects. The authors call for future prospective, randomized controlled trials to confirm these findings.

The research adds to a growing body of work exploring integrated and neuromodulatory approaches to auditory health. For instance, studies on vagus nerve stimulation for tinnitus also investigate how stimulating neural pathways can alter auditory processing. The sustained effect seen here warrants further investigation into the physiological mechanisms behind combined acupuncture, moxibustion, and cupping.

For patients considering this approach, the study underscores the importance of a standardized protocol administered by trained practitioners and the value of tracking symptoms over an extended period to fully assess benefit. As with managing any chronic condition, a multi-faceted approach that includes sound therapy and stress management, akin to good sleep hygiene practices, is often recommended.

Source: Zhu, Y., Fang, K., & Fang, L. (2026). Short- and long-term symptom changes following combined acupuncture, moxibustion, and cupping therapy for primary tinnitus: a retrospective cohort study. Frontiers in Neurology. DOI: 10.3389/fneur.2026.1869226.